title: Unintentional strangulation by a cervical collar after attempted suicide by hanging.
abstract: We report the case of a young man who attempted suicide by hanging and whose neurological status deteriorated until the cervical collar, that had been correctly placed by the prehospital team, was removed. We discuss the physiopathological mechanisms leading to death in hanging that is, a blockage of the blood stream to the brain leading to vasogenic and cytotoxic cerebral edema rather than asphyxia or spinal fracture. Our case supports the early removal of neck stabilization devices that can dangerously harm the patient after an attempted suicide by hanging, by increasing intracerebral pressure.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Schaffner Hospital, Lens, France. malcolmlemyze@yahoo.fr
authors.forename: Malcolm
authors.initials: M
authors.lastname: Lemyze
authors.forename: Aurore
authors.initials: A
authors.lastname: Palud
authors.forename: Raphael
authors.initials: R
authors.lastname: Favory
authors.forename: Daniel
authors.initials: D
authors.lastname: Mathieu
mesh_terms: D000328:Adult; D001237:Asphyxia / Q000209:etiology / Q000628:therapy*; D020878:Device Removal; D004632:Emergency Medical Services / Q000379:methods; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D007103:Immobilization / Q000295:instrumentation* / Q000379:methods; D019586:Intracranial Hypertension / Q000209:etiology* / Q000517:prevention & control; D007427:Intracranial Pressure; D007442:Intubation, Intratracheal; D008297:Male; D019838:Neck Injuries / Q000517:prevention & control*; D009989:Orthotic Devices / Q000009:adverse effects* / Q000706:statistics & numerical data; D012121:Respiration, Artificial; D018570:Risk Assessment; D013406:Suicide, Attempted