Magnetic Resonance Imaging Neurological Findings in Indian Patients who Survived Suicidal Hanging - A Retrospective Study

Document Type : Original Article

Authors

1 Department of Radiodiagnosis, North Bengal Medical College and Hospital, India.

2 Department of Forensic Medicine and Toxicology, North Bengal Medical College and Hospital, India.

3 Department of General Medicine, North Bengal Medical College and Hospital, India.

Abstract

Background: Hanging is a common mode of suicide. Every year, more than 100,000 people 
commit suicide in our country. Although there are a few studies describing Computed 
Tomography (CT) findings of the neuroaxis in cases of hanging, studies describing findings in 
Magnetic Resonance Imaging (MRI) are only a handful. The reason is that most of these patients 
usually die due to a narrow fatal period of 3 to 5 minutes before they reach the hospital. Among 
those who reach the hospital, the poor general condition doesn’t allow the long time required for 
an MRI.
Method: A retrospective study was conducted where the neuroimaging findings in MRI in 
patients referred from various departments with a history of hanging between June 2020 to June 
2023 were analyzed. 
Results: The study included 74 cases of non-fatal hanging, with only 29.72% of cases showing 
neuroimaging abnormalities (NIA). Adult-type hypoxic-ischemic encephalopathy was the most 
common NIA (13.51%), with fronto-parieto-occipital lobe involvement in 100% and temporal
lobe involvement in 40% of cases. Spinal cord injury manifesting as cord signal hyperintensity 
was seen among 18.18% of the study population. Other miscellaneous findings included 
vascular, bony, spinal cord, and neck muscle injuries in 18.18%,18.18%,9%, and 37.84% cases 
respectively.
Conclusion: Most cases of non-fatal hanging show no pathological NIA. Among those with 
NIA, the findings are predominantly reflective of acute global hypoxic injury. Further 
investigation and large-scale studies are needed to better understand the pathophysiology of the 
condition and prognosticate these patients based on neuroimaging findings.

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