Prolonged delirium secondary to hypoxic ischemic encephalopathy following complete hanging

Abstract

Background: Delirium is a common disorder, and can occur in children and adults. It is short lasting, with duration ranging from hours to days. However, prolonged delirium can occur in people with brain damage. Hypoxic ischemic encephalopathy (HIE) is a condition that occurs when the entire brain is deprived of adequate oxygen supply. HIE results in neurological injury and long term dysfunction. Outcome of HIE ranges from significant changes in personality, impairment in memory, cognition and attention, to coma and vegetative states. Only a quarter of patients survive to be discharged from hospital. There are very few case reports of prolonged delirium secondary to HIE following hanging. Case description: A 27 year old Asian man with alcohol dependence syndrome developed prolonged delirium (more than two months) following HIE subsequent to hanging. Discussion: Prolonged delirium has been reported in 1/3rd cases of delirium. Risk factors for prolonged delirium are increasing age, severe delirium, increasing number of medical conditions. Prolonged delirium was found to be associated with poor functional outcome and increased mortality. Conclusion: Our case report highlights the importance of early detection and management of prolonged delirium.

Keywords

• prolonged delirium; hypoxic ischemic encephalopathy; hanging