Anoxic Brain Injury: A Subtle and Often Overlooked Finding in Non-Fatal Intimate Partner Strangulation

Abstract

BackgroundA paucity of literature exists dedicated to the identification of anoxic brain injury in patients that survive non-fatal intimate partner strangulation (NF-IPS). While some individuals report experiencing symptoms of brain hypoxia followed by a loss of consciousness, other individuals report symptoms of brain hypoxia prior to amnesia, rendering some unable to recall loss of consciousness (LOC). ObjectiveUsing a standardized clinical assessment tool, the purpose of this retrospective analysis is to describe anoxic brain injury symptom prevalence in a sample of patients reporting NF-IPS. MethodsOne hundred and ninety-one unique patients, reporting a total of 267 strangulation events, were assessed by a member of the Shasta Community Forensic Care Team utilizing the Strangulation Hypoxia Anoxia Symptom TBI Assessment (SHASTA) tool. The sample is 98% female and includes adult patients ages 18–68. Examination records were categorized based on the presence or absence of hypoxia and anoxia symptoms. This manuscript utilizes the STROBE checklist. ResultsAmnesia was reported in 145 of the 267 strangulations (54.3%). Of those, 74 reported LOC (51.0%) while 71 did not recall LOC (49.0%). ConclusionsWithin our sample, 49% of patients with amnesia did not recall losing consciousness, demonstrating that LOC is an imperfect measure of anoxia for patients following NF-IPS. Healthcare providers examining NF-IPS patients should inquire about additional symptoms of hypoxia and amnesia, which can be captured on the SHASTA tool.