Embolic Strokes after Self-Hanging

This is somewhat unusual case. The patient in his 50’s presented after a suicide attempt via self-hanging. The patient had a cardiac arrest immediately after he was found. The heart rhythm was reported to be asystole by the paramedics. He was successfully resuscitated after ten minutes of CPR.

Therapeutic hypothermia protocol was initiated and the patient subsequently was taken off the ventilator. After his sedation was discontinued, he was noted to have several neurological deficits including right arm weakness.

MRI brain confirmed the presence of several bilateral embolic strokes. There was no dissection of his carotid arteries on the MRA of the brain/neck.

The etiology of these embolic strokes is unclear at this point. I suspect that several atherosclerotic plaques were dislodged as a result of the neck compression due to self-hanging. The patient recovered with some neurological deficits and was discharged to Rehab.