PubMed1989
A case of a survivor who showed alpha coma after an attempted suicide by hanging was reported. A 19 years old woman was admitted to the hospital because of respiratory arrest following a hanging attempt on October 10, 1987. She was found pendent completely. On admission she was comatose and the pupils were not reactive to light. The systolic blood pressure was 60 mmHg and immediately an endotracheal intubation was instituted. After six hours from the onset, the spontaneous respiration was restored and the pupils reacted briskly to light. At 48 hours later she was still comatose, presenting flaccid quadriplegia with no responses to stimulations. An EEG showed a moderate amount of regular, 8 approximately 10 Hz, 10 approximately 50 microV potentials distributed predominantly on the centro-parieto-occipital regions. This alpha rhythm had persisted until 72 hours from the onset, and subsequently diffuse 5 approximately 7Hz, 10 approximately 40 microV slow activity replaced the alpha frequency at 120 hours after the attempt. On the 5th hospital day the hyperbaric oxygen therapy was given and on the 7th day she had become conscious, but showed the apallic syndrome. The both auditory and somatosensory evoked potentials were normal. On the 45th day the brain MRI revealed diffuse cerebral cortical atrophy, although no lesions were visualized in the brain stem. She showed gradual progress towards neurologic recovery. This is the first presentation of a survivor from alpha coma caused by anoxic encephalopathy following a hanging attempt.