- Look at the map to Shepherd's Glen and Silent Hill. Count all the horror directors and writers.
- As with most of the Silent Hill franchise, there's a direct reference to Jacob's Ladder. This one comes right at the start, with Alex strapped to a gurney and seeing horrifying things in the hospital around him, mimicking a very similar scene in Jacob's Ladder.
- The achievement you get for obtaining the circular saw is called "Rising Tension".
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