Pediatric hanging and strangulation: is vascular injury a true risk?

Background Acute screening of pediatric strangulation and hanging injuries has evolved at many institutions to include cervical arterial vascular imaging. As current standards in pediatric imaging support less radiation exposure and increased imaging appropriateness, it is questionable whether vascu...

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Bibliographic Details
Published in:Pediatric radiology 2021-09, Vol.51 (10), p.1889-1894
Main Authors: Kline-Fath, Beth M., Seman, Jessica M., Zhang, Bin, Care, Marguerite M.
Format: Article
Language:English
Subjects:
Angiography
Brain
Brain injury
Computed tomography
Edema
Imaging
Injuries
Magnetic resonance imaging
Medical imaging
Medicine
Medicine & Public Health
Neck
Neuroimaging
Neuroradiology
Nuclear Medicine
Oncology
Original Article
Patients
Pediatrics
Population studies
Radiation effects
Radiology
Spine (cervical)
Strangulation
Ultrasound
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Summary:Background Acute screening of pediatric strangulation and hanging injuries has evolved at many institutions to include cervical arterial vascular imaging. As current standards in pediatric imaging support less radiation exposure and increased imaging appropriateness, it is questionable whether vascular arterial injury is a true risk in this population. Objective To determine the role of cervical vascular arterial imaging in the evaluation of pediatric hanging and strangulation injuries. Materials and methods This is a retrospective study of patients who present at a Level 1 pediatric trauma center with a history of hanging and strangulation injuries. All relevant studies, including computed tomography (CT) angiography of the neck, contrast-enhanced neck CT, cervical magnetic resonance (MR) angiography, magnetic resonance imaging (MRI) and/or CT of the brain and cervical spine and associated clinical records, were reviewed. Results Sixty-six patients were identified, 60 with vascular arterial imaging studies. No vascular injury was identified. Soft-tissue injury was noted in 20/66 (30%) patients and craniocervical injury was suspected in 2/66 (3%), but no cervical spine fracture was identified. Only 49 patients had brain imaging, with 7/49 (14%) demonstrating changes consistent with cerebral edema, which correlated negatively with survival ( P
ISSN:0301-0449
1432-1998
DOI:10.1007/s00247-021-05056-1