Abstract
Choking-induced cardiac arrest leading to hypoxic brain injury is a rare and life-threatening event. We report the case of a 73-year-old man who collapsed while breaking his fast during Ramadan due to food aspiration. He was successfully resuscitated after prolonged cardiopulmonary resuscitation (CPR). Upon admission, he was intubated, and a large amount of food debris was suctioned from his airway. Neuroimaging revealed global cerebral hypoperfusion, early hypoxic-ischemic encephalopathy, and microhemorrhages in the basal ganglia and temporal lobes, suggestive of reperfusion injury. Electroencephalography (EEG) indicated severe cerebral dysfunction. Despite supportive intensive care, neurological reassessment revealed fixed pupils and absent brainstem reflexes, indicating a poor prognosis. This case underscores the importance of prompt airway management and highlights the diagnostic role of imaging and neurophysiology in prognostication following choking-related cardiac arrest.