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An In Vivo Duo-color Method for Imaging Vascular Dynamics Following Contusive Spinal Cord Injury
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Neuroimaging in Non-fatal Strangulation: a Retrospective Analysis of Injury Patterns, Clinical Features and

Katja Döring1, Zaid Abdel-Muhdy2, Athanasia Warnecke3

  • 1Institute for Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. doering.katja@mh-hannover.de.

Clinical Neuroradiology
|December 9, 2025
PubMed
Summary

Severe strangulation injuries are rare. Computed tomography (CT) and magnetic resonance imaging (MRI) can help diagnose injuries, with CT being more common, but MRI may be better for specific cases.

Keywords:
Computed Tomography AngiographyEvidence-Based Emergency MedicineInternal Carotid Artery DissectionMagnetic Resonance ImagingSelf Injurious BehaviorSuicide Attempt

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Area of Science:

  • Medical Imaging
  • Forensic Medicine
  • Trauma Surgery

Background:

  • Strangulation injuries, both self-inflicted (SIS) and non-self-inflicted (NSIS), require accurate diagnosis.
  • Computed tomography (CT) and magnetic resonance imaging (MRI) are used to evaluate these injuries.
  • Understanding injury patterns and diagnostic utility is crucial for patient management.

Purpose of the Study:

  • To determine the incidence and patterns of injuries following SIS and NSIS.
  • To evaluate the diagnostic effectiveness of CT and MRI in detecting strangulation-associated injuries.
  • To identify risk factors associated with strangulation-associated injuries.

Main Methods:

  • Retrospective analysis of 106 patients (124 strangulation events) from 2013-2024.
  • Patients underwent CT and/or MRI following SIS or NSIS.
  • Analysis included demographics, strangulation mechanism, clinical symptoms, and imaging findings for injuries like hyoid-larynx-complex (HLC) fractures, soft tissue hematoma (STH), and blunt cervicovascular injury (BCVI).

Main Results:

  • Most cases (80.6%) were SIS, primarily ligature strangulation.
  • Severe strangulation-associated injuries were infrequent (11 patients), with HLC fractures and STH being most common.
  • Older age, male sex, near-hanging, and intubation were associated with increased injury risk.

Conclusions:

  • Severe strangulation-associated injuries are uncommon.
  • CT is useful but should be selectively applied, especially in alert patients without clear clinical signs.
  • MRI may offer advantages for younger patients and forensic evaluations, particularly in NSIS cases.