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[Hanging survivor showing alpha coma--a case report].

J Satoh, H Murase, H Tukagoshi

    Rinsho Shinkeigaku = Clinical Neurology
    |May 1, 1989
    PubMed
    Summary

    A survivor of attempted hanging developed alpha coma due to anoxic encephalopathy. This case is the first documented recovery from alpha coma, showing gradual neurological improvement after treatment.

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    Area of Science:

    • Neurology
    • Neuroscience
    • Critical Care Medicine

    Background:

    • Attempted suicide by hanging can lead to severe hypoxic-ischemic brain injury.
    • Alpha coma is a rare electroencephalogram (EEG) pattern associated with poor prognosis in coma patients.

    Observation:

    • A 19-year-old woman presented with respiratory arrest and coma after a hanging attempt.
    • Initial presentation included unreactive pupils and low blood pressure, requiring endotracheal intubation.
    • EEG revealed persistent alpha rhythm (8-10 Hz) for 72 hours, followed by diffuse slow activity.

    Findings:

    • The patient developed flaccid quadriplegia and remained comatose for 48 hours.
    • Hyperbaric oxygen therapy was initiated on day 5, leading to consciousness on day 7, but with apallic syndrome.
    • Brain MRI at 45 days showed diffuse cerebral cortical atrophy without brainstem lesions.

    Implications:

    • This case represents the first reported survivor of alpha coma secondary to anoxic encephalopathy from hanging.
    • The findings suggest potential for neurological recovery even in severe alpha coma cases with appropriate interventions.
    • Further research is warranted to understand the pathophysiology and long-term outcomes of alpha coma survivors.

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