Evidence mapPaperPMID 41364213Full record

ArticleClinical neuroradiology2026

Neuroimaging in Non-fatal Strangulation: a Retrospective Analysis of Injury Patterns, Clinical Features and Diagnostic Utility.

Katja Döring, Zaid Abdel-Muhdy, Athanasia Warnecke, Michael Klintschar, Heinrich Lanfermann, Stefan Bleich, Johanna Seifert

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Article in Clinical neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

7 authors.

Katja DöringInstitute for Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. doering.katja@mh-hannover.de.ORCID http://orcid.org/0000-0002-6965-8906
Zaid Abdel-MuhdyInstitute for Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Athanasia WarneckeDepartment of Otolaryngology Head and Neck Surgery, Hannover Medical School, 30625, Hanover, Germany.
Michael KlintscharInstitute of Legal Medicine, Medical University Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Heinrich LanfermannInstitute for Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Stefan BleichDepartment of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Johanna SeifertDepartment of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the incidence and patterns of injuries after non-fatal self-inflicted (SIS) and non-self-inflicted strangulation (NSIS) and evaluate diagnostic utility of computed tomography (CT) and magnetic resonance imaging (MRI).

methodsSingle-center retrospective analysis (2013-2024) of patients undergoing CT and/or MRI following SIS/NSIS. Demographics, psychiatric comorbidity, strangulation mechanism, clinical symptoms and imaging findings were analyzed. Imaging was assessed for strangulation-associated injuries (e.g., fractures of the hyoid-larynx-complex [HLC], soft tissue hematoma [STH], blunt cervicovascular injury [BCVI]). Descriptive statistics were performed to detect risk factors for strangulation-associated injuries.

results106 patients (55.7% female; mean age 40.2 years) and 124 events of strangulation with subsequent neuroimaging were included (CT: 96.8%, MRI: 3.2%). SIS comprised 80.6% of cases, mostly ligature strangulation (68.0%), followed by near-hanging (29.0%). NSIS accounted for 18.5% of cases. Eleven patients sustained strangulation-associated injuries, primarily HLC fractures and STH (6 cases each), but no BCVI. Older age (odds ratio: 1.04; 95% confidence interval: 1.01-1.07; p = 0.021) showed a weak association and male sex (6.32, 1.31-30.59, p = 0.022), near-hanging (12.36, 3.19-47.81, p < 0.001) and intubation (8.65, 2.04-36.78, p < 0.001) a moderate association with strangulation-associated injuries. We identified a distinct patient subgroup with recurrent SIS, characterized by predominant female sex, younger age and psychiatric disorders presenting with emotional instability. Injuries were not detected in any of these cases.

conclusionSevere strangulation-associated injuries are rare. CT should be used selectively, particularly in alert patients lacking relevant clinical findings. MRI may be preferable in younger patients and for forensic evaluation, particularly in NSIS.

Indexed as

AsphyxiaMagnetic Resonance ImagingNeck InjuriesNeuroimagingSelf-Injurious BehaviorTomography, X-Ray ComputedAdultAgedFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesRisk FactorsYoung AdultComputed Tomography AngiographyEvidence-Based Emergency MedicineInternal Carotid Artery DissectionMagnetic Resonance ImagingSelf Injurious BehaviorSuicide Attempt

Identifiers

PMID41364213
PMCPMC13319664

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.