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Asphyxia
Published in Kevin L. Erskine, Erica J. Armstrong, Water-Related Death Investigation, 2021
Strangulation represents a type of asphyxia in which an object causes compression of the blood vessels of the neck with or without concomitant compression of the larynx or trachea. The major mechanism of death in this type of asphyxia is the impairment of O2-rich blood flow from the heart up through the carotid arteries within the neck and to the brain, giving rise to cerebral hypoxia. This also involves compression of the jugular veins within the neck, thus impeding blood flow from the head and brain back to the heart. It is the venous compression with intermittent or incomplete compression of the carotid arteries that gives rise to petechial hemorrhages of the face and conjunctivae.3 These are seen in homicidal ligature and manual strangulation deaths and occasionally in deaths due to suicidal hanging. Additional examples of strangulation are choke/bar arm hold and a carotid sleeper hold. Manual strangulations are always homicidal in manner since one would be unable to maintain compression of his or her own neck vessels after the loss of consciousness since the hand(s) would fall away at that point. Manual strangulations and homicidal ligature strangulations can be accomplished because there is some kind of disparity between the opposing individuals, such as strength or drug or alcohol impairment (i.e., adult vs. infant, male vs. female, or sober adult male vs. highly intoxicated adult male).
Extracorporeal membrane oxygenation
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Thomas Pranikoff, Ronald B. Hirschl
Ultrasound is used to evaluate the right internal jugular vein for patency and size. It is critical to be sure the vein is large enough to accommodate the cannula selected to prevent vein injury. The diameter in millimeters multiplied by three will yield the French size. The vein is accessed 2 cm superior to the clavicle under direct ultrasound visualization with a micropuncture needle (5 Fr micropuncture access kit, Cook Medical, Bloomington, IN). A flexible 0.45 mm (0.018 inch) × 40 cm (10 inch) guidewire with flexible tip is advanced into the right atrium using fluoroscopy. If guidewire placement is unsuccessful, conversion to a semi-open or open technique should be considered. A 5 Fr coaxial catheter/dilator is advanced over the guidewire and the inner cannula removed. This is then replaced with a 0.89 mm (0.035 inch) J-tip guidewire and either a 13 Fr or a 16 Fr Origen venovenous ECMO cannula (Origen Biomedical Inc., Austin, TX) is selected.
Disorders of Circulation of the Cerebrospinal Fluid
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
IIH is a diagnosis of exclusion and should be distinguished from other causes of elevated ICP: Lyme disease.Bacterial meningitis.Viral meningitis.Central nervous system (CNS) lupus.CNS sarcoidosis.Cerebral venous sinus thrombosis.Jugular vein thrombosis.Primary and metastatic brain tumors.Hydrocephalus.Subdural hematoma.
Unilateral Internal Jugular Vein Thrombosis Revealing Behçet’s Disease: Through the Eyes of the Ophthalmologist
Published in Neuro-Ophthalmology, 2023
Imad Messafi, S. Chariba, A. Maadane, R. Sekhsoukh
BD is a relapsing and multi-systemic vasculitis affecting vessels of all sizes.1,2 Diagnosis is based on the ISG and ICBD criteria.2 CVT is found in 8–12% of patients with BD.2 Vascular involvement in BD is found in 40% of cases.3 Jugular vein thrombosis is an extremely rare presentation, since thrombosis in BD is usually found in the legs.4 In a study by Kuzu et al., only one out of 1200 patients had a jugular vein thrombosis.5 Meanwhile, Aguiar de Sousa et al.’s systematic review of 23 studies including 249 patients found only four cases of jugular vein thromboses (2.3%) out of 170 cases where the site was recorded.1 The second peculiarity in our case is the presence of multiple CVT (internal jugular vein extending to the sigmoid sinus and the superior sagittal sinus). In the previously cited review, more than one sinus was occluded in 45/170 cases (26.5%).1 The usual clinical presentation of CVT includes headaches, blurred vision and meningeal syndrome. Diplopia was only found in 27.5% of patients in the Alghamdi et al. cohort, although it was the principal symptom in our case.6
The neuropsychological outcomes of non-fatal strangulation in domestic and sexual violence: A systematic review
Published in Neuropsychological Rehabilitation, 2022
Helen Bichard, Christopher Byrne, Christopher W. N. Saville, Rudi Coetzer
First, the larynx can be obstructed, cutting off airflow to the lungs (i.e., asphyxiation, leading to hypoxia), which may continue after pressure has been lifted if the neck structure has been damaged (e.g., hyoid fracture). Second, jugular veins can be occluded, leading to venous congestion, increased intracranial pressure, decreased respiration, and possible pinpoint haemorrhage (petechiae). Third, there is risk of internal carotid artery occlusion, restricting blood flow to the brain (i.e., ischaemic). This is more likely to happen when the attacker is facing the victim. If pressure is at the base of the neck, vertebral arteries may also be affected. Again, this may continue once pressure has been removed if there has been arterial dissection. Fourth, there may be triggering of the carotid sinus reflex, leading to dysrhythmia, possible cardiac arrest, and thus further lack of blood to the brain (hypoxic-ischaemic). Finally, the thyroid gland can be damaged, resulting in possible ‘thyroid storm’, in which acute hyperthyroidism can cause congestive heart and multi-organ failure.
Naringenin: a potential natural remedy against methotrexate-induced hepatotoxicity in rats
Published in Drug and Chemical Toxicology, 2022
Alireza Malayeri, Reza Badparva, Mohammad Amin Mombeini, Layasadat Khorsandi, Mehdi Goudarzi
Twenty-four hours after the final administration, the animals were anesthetized using a combination of ketamine and xylazine (60/6 mg/kg, i.p.). Blood samples were collected from the jugular vein. The serum was separated through centrifugation for 10 min at 1000 g and stored at −20 °C until further analysis (Rezaei et al.2016, Nesari et al.2019). For histological analysis, 10% phosphate-buffered formalin was used to fix the hepatic tissue sections. The remaining part of the specimen in ice-cold phosphate buffer (pH: 7.4; 1/10 w/v) was homogenized using a homogenizer (WiseTis HG-150D, PMI-Labortechnik GmbH Company, Germany), followed by centrifugation for 10 minutes at 10 000×g (4 °C). For subsequent analyses, the clear supernatant was stored frozen at −70 °C. To determine the total protein content in the homogenized tissue supernatant, Bradford assay was applied (Bradford 1976).