Late neuropathological consequences of strangulation

Richard K. Simpson, J. Clay Goodman, Emilie Rouah, Nancy Caraway, David S. Baskin

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)171-185
Number of pages15
Issue number3
StatePublished - Sep 1987


  • Brain death
  • Neuropathology
  • Persistent vegetative state

ASJC Scopus subject areas

  • Nursing(all)
  • Cardiology and Cardiovascular Medicine


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