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J Neurol Neurosurg Psychiatry 2009;80:908-909 doi:10.1136/jnnp.2009.172312
  • Neurological picture

Reversible posterior leukoencephalopathy syndrome caused by hanging

  1. S Takeuchi1,
  2. Y Takasato1,
  3. M Homma2
  1. 1
    Department of Neurosurgery, National Hospital Organisation Disaster Medical Centre, Japan
  2. 2
    Department of Emergency Medicine, National Hospital Organisation Disaster Medical Centre, Japan
  1. Dr S Takeuchi, Department of Neurosurgery, National Hospital Organisation Disaster Medical Centre, 3256 Midori-cho, Tachikawa-shi, Tokyo 190-0014, Japan; s.takeuchi{at}room.ocn.ne.jp
  • Accepted 15 January 2009

CASE REPORT

A 29-year-old man was referred after attempting suicide by hanging himself. On admission, blood pressure was 127/71 mm Hg, heart rate 168/min and the patient had a score of 11 on the Glasgow Coma Scale. Pupils were normal in size and equal, and reacted to light promptly. Neurological examination revealed no motor weakness or sensory disturbance. The patient was intubated because of the risk of an obstructed airway. Head CT on admission was normal. On day 4, the patient became alert and was extubated. On day 7, the patient complained of binasal inferior quadrant hemianopsia. On day 9, head CT showed low density areas in the white matter in the bilateral occipital lobes, with partial haemorrhagic change (fig 1A). MR imaging demonstrated hyperintensity on T2 weighted …

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