Cerebral infarction due to carotid artery injury caused by hanging: case report

Background. Hanging is a common method of suicide that generally causes sudden death owing to compression of the carotid artery and trachea. As hanging leads to loss of consciousness and death in a very quick manner, almost all individuals are found while still hanging from the neck. Case report. We experienced a case in which the ability to act was maintained after hanging. The hanging caused dissection of the medial layer of the internal carotid artery, leading to thrombus formation, followed by extensive and fatal cerebral infarction. From the autopsy, we observed findings indicative of delayed death and speculated that approximately 24 hours may have passed since the onset of cerebral infarction. Conclusions. Pathological exploration of the internal carotid artery might be useful for the diagnosis of hanging in cases with an interval between hanging and death or in those with unclear ligature marks. Conversely, if the internal carotid artery is injured, hanging should be suspected.