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Demographics, psychiatric comorbidity, strangulation mechanism, clinical symptoms and imaging findings were analyzed. Imaging was assessed for strangulation-associated injuries (e.g., fractures of the hyoid-larynx-complex [HLC], soft tissue hematoma [STH], blunt cervicovascular injury [BCVI]). Descriptive statistics were performed to detect risk factors for strangulation-associated injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      106 patients (55.7% female; mean age 40.2 years) and 124 events of strangulation with subsequent neuroimaging were included (CT: 96.8%, MRI: 3.2%). SIS comprised 80.6% of cases, mostly ligature strangulation (68.0%), followed by near-hanging (29.0%). NSIS accounted for 18.5% of cases. Eleven patients sustained strangulation-associated injuries, primarily HLC fractures and STH (6\u00a0cases each), but no BCVI. Older age (odds ratio: 1.04; 95% confidence interval: 1.01\u20131.07;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.021) showed a\u00a0weak association and male sex (6.32, 1.31\u201330.59,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.022), near-hanging (12.36, 3.19\u201347.81,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090.001) and intubation (8.65, 2.04\u201336.78,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090.001) a\u00a0moderate association with strangulation-associated injuries. We identified a\u00a0distinct patient subgroup with recurrent SIS, characterized by predominant female sex, younger age and psychiatric disorders presenting with emotional instability. Injuries were not detected in any of these cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Severe strangulation-associated injuries are rare. CT should be used selectively, particularly in alert patients lacking relevant clinical findings. MRI may be preferable in younger patients and for forensic evaluation, particularly in NSIS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00062-025-01597-2","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T10:54:39Z","timestamp":1765277679000},"page":"473-484","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuroimaging in Non-fatal Strangulation: a\u00a0Retrospective Analysis of Injury Patterns, Clinical Features and Diagnostic Utility"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6965-8906","authenticated-orcid":false,"given":"Katja","family":"D\u00f6ring","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid","family":"Abdel-Muhdy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasia","family":"Warnecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Klintschar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinrich","family":"Lanfermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Bleich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Seifert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"1597_CR1","unstructured":"World Health Organization: Suicide. 2025. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/suicide. 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