Neurological Outcomes Following Suicidal Hanging: A Prospective Study of 101 Patients

Area of Science:

• Neurology
• Emergency Medicine
• Trauma Care

Background:

• Survivors of suicidal hanging exhibit a wide spectrum of neurological outcomes, ranging from full recovery to severe brain damage.
• Existing literature primarily consists of retrospective studies and case series, highlighting a need for prospective research.

Purpose of the Study:

• To prospectively investigate the neurological outcomes in patients following suicidal hanging.
• To identify factors associated with neurological deficits and amnesia in this patient population.

Main Methods:

• A prospective observational study conducted from July 2014 to July 2016.
• Inclusion of consecutive patients admitted to emergency and medicine wards.
• Analysis of clinical, radiological findings, in-hospital course, and 1-month post-discharge outcomes.

Main Results:

• Out of 101 patients, 6 died and 4 had residual neurological deficits.
• Retrograde amnesia (inability to recall the hanging event) was observed in 39 patients.
• Amnesia was significantly associated with hypotension, pulmonary edema, low Glasgow Coma Scale (GCS) score (<8), need for mechanical ventilation, and cerebral edema.

Conclusions:

• The majority of suicidal hanging survivors achieve recovery without long-term neurological sequelae.
• Routine cervical spine imaging may not be necessary for all patients, including those with a low GCS.
• Retrograde amnesia appears to be a more frequent occurrence than previously recognized, warranting further investigation.