Spontaneous intrathyroidal hemorrhage is a rare phenomenon in medicine. Previous reports have described precipitating factors that lead to the condition; however, there is no prior report of the condition in a patient with a hypertensive emergency. The authors presented a case of a deceased 59-year-old male brought to the hospital with loss of consciousness in an episode of hypertensive emergency. The subsequent autopsy revealed hemorrhagic stroke as the cause of death and an incidental finding of intrathyroidal hemorrhage in a thyroid nodule. Further literature review revealed the demographic data as well as the presentation and progression of the patients with the condition. No cases of intrathyroidal hemorrhage and hypertensive emergency have been reported. Airway compression in thyroid hemorrhage can be rapid and fatal. In most cases, surgical intervention is usually required. In cases of spontaneous hemorrhage, there were always thyroid lesions. The present case is an early report of spontaneous intrath roidal hemorrhage in a hypertensive emergency. Airway protection should be prioritized in case of intrathyroidal hemorrhage. Furthermore, attempt should be made to identify the underlying thyroid pathology. Extensive history taking can also guide attending physicians and pathologists to distinguish between spontaneous and traumatic hemorrhage. In addition, to prevent a fatal consequence, neck examination should also be performed in patients with hypertensive emergency.

Keywords: Thyroid; Hemorrhage; Hypertensive emergency; Hemorrhagic stroke; Intracerebral hemorrhage; Autopsy

DOI: 10.35755/jmedassocthai.2022.12.13711

Received 30 May 2022 | Revised 28 September 2022 | Accepted 11 October 2022