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If spinal cord injury is not the immediate cause then occlusion of the major blood vessels to the brain usually is. Both venous and arterial blockage contribute to death. When the internal jugular veins are collapsed the brain swells and and chokes off the small vessels feeding the substance of the brain. The carotid arteries, which deliver oxygen rich blood, take more force to collapse given their deeper position in the neck and the higher pressures of blood flowing within. When cerebral circulation is compromised in any event, death occurs within 4-5 minutes. The heart may continue to beat autonomously for up to 10-15 minutes (since it has its own pacemaker) after the brain is no longer resurrectable. The body and limbs may move after death because of nervous and muscular reflexes. The face becomes blue and engorged.
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