Vascular Imaging is the Only Reliable Method to Exclude Blunt Cerebrovascular Injury Post Hanging or Strangulation

Area of Science:

• Medical Imaging
• Trauma Surgery
• Vascular Surgery

Background:

• Strangulation and hanging injuries are common forms of self-harm.
• The occurrence of blunt cerebrovascular injury and its clinical correlation in these cases is not well understood.
• Optimal imaging strategies for these injuries remain undetermined.

Purpose of the Study:

• To determine the incidence of blunt cerebrovascular injury in patients with strangulation or hanging injuries.
• To identify clinical or laboratory predictors of vascular injury in these patients.
• To inform imaging guidelines for patients sustaining strangulation or hanging injuries.

Main Methods:

• A multicenter retrospective review of a prospectively collected database.
• Inclusion of all patients presenting with hanging or strangulation injuries.
• Performance of CT angiogram on all patients, with subsequent statistical analysis of demographics, clinical data, laboratory results, and imaging findings.

Main Results:

• Over an 11-year period, 194 patients were identified.
• Only 4.6% of patients had positive findings on CT angiogram.
• No correlation was found between positive imaging findings and clinical or laboratory data.
• The in-hospital mortality rate was 1%, with no deaths associated with vascular injury.

Conclusions:

• The incidence of vascular injury in strangulation or hanging injuries is 4.6%.
• Clinical and laboratory findings cannot reliably exclude the presence of vascular injury.
• CT angiogram is recommended for all patients with strangulation or hanging injuries to detect potentially serious vascular damage.