Neuropsychiatric sequelae of attempted hanging and diagnostic dilemmas

"I don't know why I am in hospital": amnesia in non-fatal hanging

There is an extreme dearth of empirical studies assessing the neuropsychiatric outcome of non-fatal hanging that indicates little attention to the area has been paid. We aimed to report the memory disturbances of 14 cases after an immediate non-fatal hanging attempt. We conducted the study from August 2020 to June 2021 and collected data from 14 hospitalized patients after an immediate non-fatal hanging attempt. We conducted series of clinical examinations to assess the memory disturbance and recorded it. Among the 14 cases, four (28.8%) were males and the rest ten (71.2%) were females. The mean age of the cases was 25.28 ± 8.19 years ranging from 15-40 years. All the cases had retrograde amnesia while six (42.9%) had both anterograde and retrograde amnesia. The current pilot study reported the distribution of memory disturbances among fourteen cases of non-fatal hanging that adds preliminary findings to the under-researched area and warrants further empirical studies to generalize the study results.

Electrophysiological and neuroimaging findings in a patient who developed visual loss after attempted suicide by hanging

PURPOSE

To report the electrophysiological and neuroimaging findings in a patient who developed visual loss after attempted suicide by hanging.

METHODS

A 45-year-old male presented with bilateral visual loss and difficulty in walking following a suicide attempt by hanging six months ago. He underwent a complete ophthalmologic examination, posterior segment optical coherence tomography (OCT), various electrophysiological tests and neuroimaging.

RESULTS

His bilateral best-corrected visual acuity was logMAR 1.08. Intraocular pressures and ocular examination were normal except for bilateral temporal disk pallor. Macular OCT showed bilateral ganglion cell layer-inner plexiform layer complex thinning. Electroretinogram showed reduced b/a wave amplitude ratio in all the dark- and light-adapted International Society for Clinical Electrophysiology of Vision protocols in both the eyes. Pattern-reversal visually evoked potential (VEP) showed delayed latency of the P100 component in both the eyes. Electrooculography showed a normal light peak-to-dark trough ratio in both the eyes. Magnetic resonance imaging (MRI) brain showed chronic infarct and gliosis in both the occipital lobes. MR angiography showed pruning of P4 segments of both the posterior cerebral artery. Perfusion imaging showed reduction of perfusion in both the parieto-occipital lobes.

CONCLUSION

Hanging survivors can develop visual loss after their recovery. The visual loss may be a result of simultaneous ischemic insult to the occipital lobe cortex, optic nerve and retina.