Subarachnoid hemorrhage and internal carotid artery dissection and occlusion following self-enucleation

Hadi Joud; Mohammad Noureldine; Ivo Peto; Jay Kumar; Jasmina Bajric; Siviero Agazzi

doi:10.4103/ajns.AJNS_183_20

Asian Journal of Neurosurgery, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(04): 1050-1054
DOI: 10.4103/ajns.AJNS_183_20

Case Report

Subarachnoid hemorrhage and internal carotid artery dissection and occlusion following self-enucleation

Hadi Joud

University of South Florida Morsani College of Medicine, Tampa, Florida

,

Mohammad Noureldine

¹Department of Neurosurgery, Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, Johns Hopkins University School of Medicine, Saint Petersburg, Florida

,

Ivo Peto

²Department of Neurosurgery and Brain Repair, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida

,

Jay Kumar

²Department of Neurosurgery and Brain Repair, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida

,

Jasmina Bajric

³Department of Ophthalmology, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida

,

Siviero Agazzi

²Department of Neurosurgery and Brain Repair, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida

› Institutsangaben

Abstract

Self-enucleation is an uncommon type of major self-injury, which may lead to severe neurological deficits and life-threatening complications, such as subarachnoid hemorrhage (SAH) and internal carotid artery (ICA) dissection and occlusion. Our patient is a 53-year-old man with a history of bipolar disorder and schizophrenia who presented with SAH, intraventricular hemorrhage, ICA dissection and occlusion, and right cerebral infarct following self-enucleation. Despite a Glasgow Coma Score of 6 on initial presentation, he improved with conservative management. He achieved a near-complete neurological recovery, with residual left lower extremity weakness and mild confusion. Self-enucleation is a major neurologic, ophthalmologic, and psychiatric emergency with a potential for serious neurological complications and contralateral visual loss. Yet, conservative management may lead to dramatic recovery.

Key-words:

Dissection - internal carotid artery - occlusion - self-enucleation - subarachnoid hemorrhage

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Referenzen

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