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


1 University of South Florida Morsani College of Medicine, Tampa, Florida, USA
2 Department of Neurosurgery, Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, Johns Hopkins University School of Medicine, Saint Petersburg, Florida, USA
3 Department of Neurosurgery and Brain Repair, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
4 Department of Ophthalmology, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida, USA

Correspondence Address:
Siviero Agazzi,
Department of Neurosurgery and Brain Repair, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida
USA
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_183_20

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.


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