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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
1   Department of Neurosurgery, Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, Johns Hopkins University School of Medicine, Saint Petersburg, Florida
,
Ivo Peto
2   Department of Neurosurgery and Brain Repair, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida
,
Jay Kumar
2   Department of Neurosurgery and Brain Repair, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida
,
Jasmina Bajric
3   Department of Ophthalmology, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida
,
Siviero Agazzi
2   Department of Neurosurgery and Brain Repair, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida
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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

Financial support and sponsorship

Nil.




Publication History

Received: 28 April 2020

Accepted: 10 August 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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