Late neuropathological consequences of strangulation

Resuscitation. 1987 Sep;15(3):171-85. doi: 10.1016/0300-9572(87)90013-x.


A case of a young man who was a victim of strangulation is presented. He arrived at the hospital in refractory status epilepticus, controlled only with intravenous pentobarbital. The initial CT scan showed mild cortical edema. Two days later, a CT scan showed diffuse cortical swelling and bilateral basal ganglia infarcts. Upon discontinuation of pentobarbital therapy, his neurological examination revealed spontaneous ventilation and a gag reflex. A CT scan 4 weeks after the insult demonstrated hypodensities in both cerebral hemispheres and hydrocephalus. EEG was isoelectric throughout his hospitalization. He survived nearly 5 months and succumbed to pneumonia. Neuropathological examination demonstrated severe encephalomalacia, multiple cystic infarcts and generalized compensatory ventriculomegaly. Microscopic examination was particularly remarkable for a pronounced gemistocytic astrocyte proliferation in the white matter. This case illustrates the long-term neuropathological consequences of severe, global hypoxia/ischemia and the paucity of intact brain required to maintain a persistent vegetative state.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain / pathology*
  • Brain / physiopathology
  • Brain Death*
  • Brain Ischemia / complications
  • Coma / diagnosis
  • Coma / etiology
  • Coma / pathology
  • Coma / physiopathology*
  • Electroencephalography
  • Humans
  • Hypoxia, Brain / complications
  • Male
  • Neck Injuries*
  • Neurologic Examination
  • Tomography, X-Ray Computed