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.