Type-III Hangman's fracture combined with serious cerebrovascular injury after near-hanging: a first case report and review of the literature

Abstract

Cervical fractures are rare after non-judicial hangings. Type-III Hangman’s fracture (HF) is an unstable injury caused typically by motor vehicle accidents or falls. We describe the first reported case of a Type-III HF combined with occlusion of the right vertebral artery and non-occlusive dissection of both internal carotid arteries caused by near-hanging. We performed a posterior approach open reduction of dislocated C2 facets and C1 to C3 fusion. Carotid dissections were managed conservatively with long-term antiplatelet therapy. The patient survived without any neurological deficit and without any significant restriction of cervical motion.

Keywords:

• Hangman’s fracture
• cervical spine injury
• carotid dissection
• near-hanging
• spine

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Ministry of Defence, Czech Republic [grant number MO 1012].