Silent Trauma: Implications of Non-Fatal Strangulation-Acquired Brain Injury - An Integrative Review

Non-fatal strangulation (NFS) is a severe form of Intimate partner violence (IPV) that can result in acquired brain injuries (ABI), yet this link is frequently overlooked. Misdiagnosis and limited awareness contribute to long-term physical and mental health complications. Evidence-based protocols for identifying and managing non-fatal strangulation-acquired brain injury (NFS-ABI) are lacking, which prevents the delivery of standardised care. Long-term outcomes remain understudied. To synthesise current evidence on the neurological and psychological sequelae of (NFS- ABI), and to identify implications for clinical practice and policy. An integrative review. A comprehensive search of eight databases was conducted. Twenty-six peer-reviewed articles met the inclusion criteria, exploring IPV-NFS and its potential link to ABI, associated neurological and psychological deficits, and implications for healthcare professionals. Findings were synthesised to inform policy and improve clinical management of NFS-ABI. Evidence indicates that NFS-ABI can lead to significant cognitive, emotional, and physical impairments. However, screening and management strategies remain inconsistent. The review highlights the urgent need for validated screening tools and clinical guidelines to ensure timely identification and intervention for survivors. Healthcare professionals require training and standardised assessment tools and protocols to recognise and manage NFS-ABI effectively. Improved detection and treatment can reduce chronic morbidity and enhance outcomes for NFS-ABI survivors. This review informs policy development and clinical practice, emphasising the importance of integrating NFS-ABI screening into health care pathways. This review contains no patient or public contribution since it was examining the neurological and psychological sequelae of (NFS- ABI), and to identify implications for clinical practice.