Magnetic resonance images in hanging

Hanging is a devastating method of suicide and unfortunately is common in Japan. Although several CT findings of the head have been reported, there have not been any reports about magnetic resonance imaging (MRI) in hanging. We report here interesting MRI findings in a patient after hanging. A 39-year-old woman was transferred to our department after attempting suicide by hanging. Respiration had probably ceased for about three minutes but heart had not stopped when she was pulled down by her father. After her father performed cardiopulmonary resuscitation, she started to breathe immediately. She was treated conservatively in our intensive care unit for 14 days, her condition became stable. Ten days after admission, MRI demonstrated symmetrical hyperintensity on T1-weighted images and relative hyperintensity on T2 weighted images in bilateral lentiform nuclei and medial thalami. There have been several reports about characteristic MRI findings in the case of acute global cerebral ischaemia caused by severe hypoglycaemia or longstanding cardiopulmonary arrest. It was postulated that these specific findings reflected tissue degeneration, deposition of mineral substances, or lipid accumulation. These MRI findings suggest that severe acute global cerebral hypoperfusion also occurs in hanging in the same way as in long-standing cardiopulmonary arrest and that hanging has devastating sequelae.