Functional neurologic and neuropsychologic outcome after near-hanging

Although hanging is a frequently used suicide method, little is known about the prognosis of patients that survived hanging (near-hanging). AIM: To describe a case report and present a literature-review on the functional neurologic outcome after near-hanging (with separate analyses for the presence of cardiac arrest and use of neuro-protection), and possible residual neuropsychological symptoms. RESULTS: Only 12,4% (bi 4,6-29,4) of patients after near-hanging with cardiac arrest had a good functional outcome, compared to 90,6% (bi 85,7-94,0) of those without cardiac arrest. Neuroprotection through targeted temperature management has no significant influence on the outcome, neither in the presence nor absence of cardiac arrest. Near-hanging victims with a good functional outcome have, at most, mild residual neuropsychological symptoms. These can manifest throughout all cognitive domains, although learning and memory are most frequently and severely affected. DISCUSSION A significant subgroup of patients after near-hanging without cardiac arrest recovers towards a good level of functioning. A range of residual neuropsychological symptoms remain apparent, which are challenges for diagnostics and suicide prevention.