Outcome of Cervical Near-Hanging Injuries

Abstract

Cervical near-hangings are referred to the Trauma Service for evaluation. Scene or ED GCS of 3 does not preclude neurologically intact survival, although mortality is high. In our study, the most useful prognostic factors were the need for airway control by intubation or cricothyrotomy, cardiopulmonary resuscitation, lower scene and ED GCS, and cerebral edema on CT Scan. Optimal evaluation includes head and neck CT and CT angiography of the neck. We plan to share these results with local authorities and encourage improvement in risk identification, with earlier involvement of mental health personnel.

Predictors of functional outcome after hanging injury

“…The same factors (dilated pupils, diminished pupillary light reflex and GCS = 3) in ED are also indictors of poor functional outcome. 2 , 3 , 6 , 7 , 11 , 15 According to our study, GCS for all deaths was 3 points ( n = 17); and there were 25 cases with GCS = 3 at scene, of which there were 17 deaths and 6 patients with poor prognosis (when they discharge, two patients with GCS = 8, two patients with GCS = 6 and two patients with GCS = 3). These six cases required tracheostomy to help breathe.…”

“… 2 , 3 The injuries resulting from hanging include hyoid bone fracture, larygotracheal fracture, carotid injury, cerebral hypoxia and pharyngeal laceration. 4 , 5 , 6 , 7 , 8 Larygotracheal injury should be considered when hoarseness, subcutaneous emphysema, dysphagia or hemoptysis appears. 9…”

“… 4 , 10 The pathophysiological mechanisms of non-judicial hanging are jugular venous compression, brain hypoxia, loss of consciousness within 15 seconds, decreased muscle tone and then death within 5 minutes from cardiac arrest due to carotid sinus stimulation or from complete airway/arterial occlusion due to soft tissue swelling. 3 , 4 , 7 , 11 , 12 …”

Legius Syndrome in a 13 Month Old Boy: A Case Report

“…Every effort must then be made for aggressive supportive management. Near hanging events rarely result in cervical spine fractures [48]. Particular attention should be paid to the victim's pulmonary function as pulmonary edema is a well-documented complication of near hanging events.…”

An overview of the mechanical asphyxia with the main emphasis on hanging

“…U literaturi je opisan slučaj uspješno izvršenog "vješanja" tako da je vrat jednostavno naslonjen na uzak prostor između užadi niskog sušila rublja dvaju postolja u vrtu16 . Nije uobičajeno da se vješanje izvrši dovoljno nasilno da bi se oštetila vratna kralježnica, što se zapravo događa kad je duljina vrpce prekratka22,23 . To se događa samo iznimno, kad osoba skoči s krova ili nekog drugog visokog mjesta s užetom oko vrata.…”