Neuropsychiatric sequelae of attempted hanging

In December, 1965, a patient was admitted to the wards at Parkside Hospital, Macclesfield, with a Korsakoff syndrome which had appeared following a suicidal hanging attempt. Strangulation as a cause of the Korsakoff syndrome appears in all surveys of the numerous causes of the disorder, from Bonhoeffer (1904) to Lewis (1961), but only one case (Whiteley, 1958) has been described in the English literature and this only briefly. Indeed, the whole subject of the neuropsychiatric sequelae of attempted hanging has received scant attention in the English literature, yet according to statistics of the Registrar-General (Stengel, 1964), hanging is the second commonest method of suicide in males in this country. Moreover, Bokonjic (1963) has collected 19 cases admitted to hospitals in Aarhus and Copenhagen between 1948–1958 suffering from the anoxic effects of attempted hanging, whilst Berczeller and Nowotny (1935) claimed to have dealt with 100 hanging survivors in the Vienna University Clinic over a ten-year period. Possibly of greater importance in justifying a review of this subject is the fact that the neuropsychiatric sequelae of attempted hanging are really those of cerebral anoxia. In this age, when surgical techniques involving interruption of the cerebral circulation are growing more frequent and when methods of anaesthesia and particularly dental anaesthesia are evoking a good deal of attention and contention, it is important that the psychiatrist should have some acquaintance with the psychological and neurological symptoms and signs that are caused by cerebral anoxia.