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Updated: Sep 12, 2025

Image Acquisition using Portable Sonography for Emergency Airway Management
Published on: September 28, 2022
Use of CTA in Strangulation Evaluation
Jee Moon1, Jonathan Lau2, Lily Kwak3
1From the Department of Radiology (J.M., C.A., D.A.L., C.G., H.A.S., J.H., D.Y., V.Y.), Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland.
Background And Purpose:
CTA is a commonly used study in the setting of strangulation-related injuries due to the concern for blunt cerebrovascular injuries (BCVIs). However, patients can present with a variety of histories and symptoms, which can make screening for at-risk populations in this group difficult. Therefore, this study aimed to identify risk factors and rates of BCVIs in the setting of strangulation-related injuries to guide imaging strategies.
Materials And Methods:
We conducted a retrospective review of 138 patients who presented with strangulation and underwent a CTA in a level II trauma center between 2019 and 2023. Patients with CTAs were identified by using a structured search of radiology reports. Clinical, demographic, and imaging findings were analyzed to assess for potential risks of BCVIs.
Results:
Among 138 patients, only 1 of 138 was found positive for a BCVI, and this patient was discharged with no complications from the injury. Two of 138 were positive for an acute cervical fracture. A variety of symptoms/findings included neck pain, loss of consciousness, bruising, tenderness, and a sore throat.
Conclusions:
In patients presenting with strangulation, the rates of BCVI and even acute cervical fractures were low. These findings suggest that broad use of CTAs in this setting may be of low diagnostic value. Further studies are needed to find more relevant symptoms and signs that could suggest the need for CTAs in this patient population to best optimize diagnosis and patient safety.
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