WOMEN’S SPECIALIST PSYCHOTHERAPIST Private Online Therapy · Worldwide · Brisbane-Based Client resources. Been choked or strangled? Please get checked.
Even if there are no marks. Even if you feel fine. Pressure on the neck can cause hidden injuries that only show up days, weeks or months later. Here’s what can happen, what to watch for, and what a medical check involves.
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If you’re in danger right now, call 000.
Go to a hospital emergency department, or call 000, if you have any of these, even hours or days afterwards:
- Trouble breathing, or a feeling your throat is closing
- A changed, hoarse or lost voice, or trouble speaking
- Pain or difficulty swallowing, or swelling in your throat, neck or tongue
- Feeling confused, faint, or passing out, or a seizure
- A drooping face, weakness or numbness in an arm or leg, slurred speech, or sudden changes to your vision (signs of a stroke)
- A sudden, severe headache, or memory loss
If you can, don’t stay on your own for the next day or two. Ask someone safe to stay with you and keep an eye on you.
PART 1WHAT YOU MIGHT BE TELLING YOURSELF
“It wasn’t that bad.” Your body may disagree.
Many people use the word ‘choked’. Doctors call it strangulation: any pressure on the outside of the neck, from hands, an arm, a knee or an object, that squeezes the airway or the blood vessels to the brain. Being held or pinned by the throat counts. If any of these thoughts sound familiar, please keep reading.
- “There weren’t any marks.”About half of people who are strangled have no visible injury at all. The damage that matters most is inside the neck and brain, where no one can see it.
- “I feel fine now.”Some of the most serious injuries, like a torn artery or swelling in the throat, can take hours, days or weeks to cause symptoms.
- “It was only a few seconds.”A few seconds is enough. In medical studies, people lost consciousness after around seven seconds of pressure on the neck, sometimes sooner.
- “I didn’t pass out.”Your brain can be short of oxygen without you blacking out. And many people don’t realise they did, because the moments around it are missing from memory.
- “My memory of it is patchy.”That’s common. When the brain is short of oxygen, it can’t lay down memories properly. Gaps aren’t you being unreliable. They’re a sign of what happened.
- “I don’t want to make a fuss.”This isn’t a fuss. Doctors in Australia treat strangulation as a serious injury, and a check-up is exactly what they’d want you to have.
PART 2WHAT’S HAPPENING IN YOUR BODY
Your neck is the lifeline to your brain.
Your neck carries the arteries that take blood and oxygen up to your brain, the veins that drain blood back down, and the airway you breathe through. All of them sit close to the surface, with very little to protect them. It takes surprisingly little pressure to squeeze them shut.
When the arteries are squeezed, your brain is starved of oxygen within seconds. When the veins are squeezed, pressure builds up in your head, which is why some people see tiny red spots in their eyes or on their face, or feel pressure behind the eyes. When the airway is squeezed, you can’t breathe, and fighting for air puts strain on your throat and lungs.
Strangulation can also trigger a freeze response. Many people say they couldn’t move, couldn’t scream and couldn’t fight back. That isn’t weakness. It’s your nervous system doing what it does when it believes you might die.
HIDDEN AND DELAYED INJURIES
Injuries that can show up later.
These are the reasons doctors want to see you, even when you look and feel okay.
- A torn artery and a blood clotThe pressure can tear the inner lining of one of the arteries in your neck (doctors call this a dissection). A blood clot can form at the tear. It may slowly block the artery, or a piece can break off and travel to your brain, causing a stroke. The risk is highest in the first two weeks, but strokes have been reported several months after a strangulation. That’s why one leading US guideline recommends scanning people who come forward up to a year afterwards. A torn artery often has no symptoms at all until the stroke, which is why it’s worth looking for.
- Swelling in the throatDamage inside the throat can swell slowly and narrow the airway. This has been reported up to 36 hours after the event.
- Brain injury from lack of oxygenEven short periods without enough oxygen can injure the brain. It can show up as headaches, dizziness, poor memory or concentration, mood changes or feeling ‘not yourself’. Being strangled more than once adds up.
- Damage to the voice box and throatA hoarse or changed voice, pain when swallowing, or a feeling of a lump in the throat can mean the voice box or the small bones in the neck have been hurt.
- Strain on the lungsFighting to breathe against a blocked airway can cause fluid to build up in the lungs, which may make you short of breath afterwards.
- If you’re pregnantStrangulation has been linked with miscarriage, because the baby relies on your oxygen too. Please tell the doctor or midwife if you’re pregnant or might be.
AN HONEST ANSWER
Can it really cause harm years later?
You may have heard that strangulation can kill someone years after it happened. Here’s what the medical evidence actually shows, because you deserve the real picture, not a scare.
Clots and strokes: the danger is greatest in the first days and weeks, and strokes have been recorded months later. A clot or stroke years later is not something the evidence shows clearly. So if it happened a long time ago and you’ve had no symptoms, it’s still worth mentioning to your GP, but please don’t panic.
Brain and body: some effects can last for years. In one US study, women reported vision problems, poor concentration, dizziness and traumatic stress years after their most recent strangulation, especially those whose strangulation had caused a brain injury. If you’ve noticed changes in your memory, focus, headaches or eyesight since, a GP can arrange a proper assessment.
The danger that lasts longest often isn’t inside your body at all. It’s the person who did it. That’s the next part.
PART 3THE WARNING SIGN DOCTORS TAKE SERIOUSLY
Strangulation is one of the strongest warning signs of future danger.
Someone who puts their hands around your neck is showing you they’re willing to take your life in their hands. That’s why police, courts and doctors now treat strangulation as one of the most serious red flags in domestic violence.
Women strangled by a partner face about seven times the risk of later being killed by that partner.Glass and colleagues, Journal of Emergency Medicine, 2008 · cited in Australian GP guidance
Strangulation is now a serious crime in its own right in every Australian state and territory, including Queensland, where it has been a separate offence since 2016. You don’t have to decide anything about police today. But please don’t carry this risk on your own. A domestic violence service can help you plan for your safety, whatever you decide (numbers at the end of this page).
PART 4WHAT A MEDICAL CHECK INVOLVES
Getting checked, step by step.
Knowing what to expect can make it easier to walk in the door. You can take this page with you.
- Choose where to go
If it happened in the last few days, or you have any of the symptoms at the top of this page, go to a hospital emergency department. If it was longer ago and you feel well, book in with your GP soon.
If it was months or years ago, it’s still worth telling your GP, especially if you’ve noticed changes in your memory, concentration, headaches, voice or eyesight.
- Use the words
Say clearly, “I was strangled,” or “Someone put pressure on my neck.” Not every doctor will think to ask, and saying it changes how they check you.
- Tell them the details that matter
How long it went on, whether you blacked out or think you might have, whether you couldn’t breathe, saw spots or lost your vision, wet or soiled yourself, or have gaps in your memory. These can feel embarrassing to say, but they’re exactly what tells a doctor how serious it was.
- Expect an examination, and possibly a scan
The doctor will check your neck, throat, eyes, breathing and nervous system. If there are warning signs, they may arrange a special CT scan of the blood vessels in your neck (a CT angiogram), which is the scan recommended for finding a torn artery. A normal ultrasound isn’t enough for this.
- Ask for it to be written down
Ask the doctor to note what happened and any injuries, and photograph marks if there are any. Your medical record can be important evidence if you ever decide to go to police, even years from now. Deciding to have it recorded doesn’t mean you have to report.
- Book a follow-up
Australian GP guidance suggests a review within about three days, then again around three months later to check your memory and thinking. If you can, keep a private note of any symptoms over the next few weeks.
Getting checked isn’t overreacting. It’s taking yourself seriously.
THE WEEKS AFTER
What to watch for.
- Face: one side drooping when you smile
- Arms: weakness or numbness in an arm or leg, or trouble lifting both arms
- Speech: slurred or jumbled speech, or trouble finding words
- Time: don’t wait to see if it passes. Call 000 and tell them you were strangled.
- Also: a sudden severe headache, sudden changes to your vision, dizziness or loss of balance, confusion, a seizure, or new trouble breathing or swallowing.
Pain on one side of your neck, face or head, or a new ringing in one ear, can sometimes be an early sign of a torn artery. See a doctor the same day and tell them about the strangulation.
PART 5WHAT IT CAN DO TO YOUR MIND
Why it can stay with you long after.
Being strangled is one of the most frightening things a person can live through. Many people say it was the moment they truly believed they were going to die. It makes sense that your nervous system would hold onto that.
Afterwards, you might notice panic when anything touches your neck, a tight collar or necklace you can’t bear, startling easily, nightmares, numbness, or a constant sense of being on guard. Some of what feels like anxiety or brain fog may also be a physical injury, which is one more reason to have the medical check first.
None of this means you’re weak or overreacting. It means your system remembers how close it came, and it’s still trying to protect you.
PART 6WHERE TO GET SUPPORT
You don’t have to work this out on your own.
- Emergency000Police · ambulance · 24/7If you’re in danger, or have any of the warning signs on this page.
- DVConnect Womensline1800 811 811Queensland · free · 24/7Crisis counselling, safety planning, and emergency transport and accommodation. Men can call DVConnect Mensline on 1800 600 636 (9am to midnight).
- 1800RESPECT1800 737 732Australia-wide · free · 24/7Counselling and support for anyone affected by domestic, family or sexual violence, by phone or online chat.
- Red Rose Foundation(07) 3065 9043Brisbane-based charityA national charity focused on high-risk domestic violence, with a particular focus on strangulation and its long-term health effects.
- Lifeline13 11 14Australia-wide · 24/7If you’re in crisis or having thoughts of harming yourself.
- Your GPBook a long appointmentAsk for a check after strangulation, and for the follow-up visits above. You can say as much or as little as you’re ready to.
WHERE I COME IN
Body first. Then the rest.
I’m not a doctor, so the medical check comes first, and I’d always rather you go and be told everything’s fine than wonder.
Once your body has been looked after, I’m here for what it’s left in your nervous system: the fear, the flashbacks, the shame that often comes with it, and the part of you that’s still braced.
If we’re already working together, bring this to our next session, and tell me whether you’ve been able to see a doctor. If anything about your safety has changed, please tell me straight away.
WHERE THIS INFORMATION COMES FROM
Sources.
The medical information on this page comes from published guidance for doctors and peer-reviewed medical journals.
- Management of non-fatal strangulation in general practiceAustralian Journal of General Practice (RACGP), 2022Australian guidance for GPs: hidden injuries, warning signs, scans, follow-up and safety advice.
- Non-fatal strangulation is an important risk factor for homicide of womenJournal of Emergency Medicine, 2008The study behind the ‘about seven times the risk’ figure.
- Recommendations for the medical evaluation of non-fatal strangulationTraining Institute on Strangulation Prevention, USA, 2022Recommends scanning for torn arteries in people who come forward up to a year afterwards.
- Long-term effects of strangulation-related brain injuryMass General Brigham, 2025Women reported vision problems and traumatic stress years after strangulation.
What happened to you was serious. You deserve to be taken seriously, starting with you.
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