Tag: Strangulation

Introduction

Postmortem findings

• Ligature  mark is  above  thyroid  cartilage,  inconplete,  bitaterally  symmetrial  and  directed  obliquely  upward extending  to  the  angles  of  mandible,  then  to  mastoid  and  finally  to  occipital protuberance.  Ligature  mark is  an example  of  imprinted/pressure/patterned  abrasion.
• There is  dribbling of saliva  from  the  angle  of the  mouth  which  is  confirmatory sign  of antemortem
• Hanging. This is  due to  irritation  of submandibular  and parotid  glands  by  ligature.
• There  may  be intimal  tear  of carotid  arteries.
• In  case  of pressure  of ligature  on cervical  sympathetic  ganglia,  the  eye on that  side is  found  open  (La  facie sympathique) .
• Fracture  of hyoid  is  usually  not seen (may be  seen  only in  l0%). Fracture of thyroid  cartilage
• (20-30 %  cases)  and fracture  of tracheal  rings  (5-l0 %)  may  be  seen.
• There  may  be  congestion  and ecchymosis (hemorrhage)  in trachea’ larynx, epiglottis  and esophagus. 
• All these  injuries  are more  common  in  strangulation  because  strangulation is  more violent  than  hanging causing  more severe  injury  to  neck structures.
• Tardieu spots (petechial  hemorrhage) are  not as  Pronounced  as  in  strangulation.

STRANGULATION

• Strangulation  is  the  form  of asphlxia  caused by  constriction  of  neck  by ligature  or some  other method,  but  without suspension  of  the  body.  So the  force  constricting the  neck is  external  force  (not  the  weight  of  the  body as  occurs  in hanging).

Depending upon  the  method  used  to  constrict  the  neck,  strangulation  can  be  divided  into:

1. Ligature strangulation  :  Neck  is  compressed by  a  ligature  of  which  usually  multiple rounds  are  given  and  no  knot is  tied.
2. Throttling  (manual  strangulation)  : Neck  is  compressed  by  one or both  hands. When neck  is  compressed by  two  palms,  it  is  known  as  palmar  strangulation.
3. Bansdola: Compression  of neck with  one or two  wooden sticlcs  or  bamboo.
4. Garrotting: It  is  compression  of  neck  by  a rope  thrown  from  behind.  Spanish windlass  is a type  of  garrotting,  which used  to  be  the  official  mode  of  execution  in  spain.  In  this,  an  iron  collor  around  the  neck was tightened  by a  screw for  strangulation.
5. Mugging  (choke  hold) :  It  is  compression  of neck by  forearm  or in  the  bend  of elbow.
6. Strangulation  by  knee/foot :  In  this,  neck  is  compressed by  knee  or foot.

Medico-legal aspects of hanging:

• Hanging is invariably suicidal, until unless otherwise proved. In a suicidal hanging, any  material available at that moment of time can be used for the act. A foot stool may be  found at the scene of the death  which is used for reaching the point of suspension.
• Tragic cases of accidental hanging are also reported where children play dangerous  games including simulation of hanging.
• Lynching is a form of homicidal hanging  where an accused  of murder  or rape is hanged in a public square by a mob as a part of carrying out justice.
• Judicial hanging:  In some countries, including India, hanging is the mode of carrying  out  capital punishment or legal execution of death sentence. The rope is allowed to drop 5 to 7 metres  according to the height and weight of the person. Bilateral fracture of the pedicle of the  second-third or third-fourth cervical  vertebrae occurs which is called hangman’s fracture.
• Sudden stop causes fracture dislocation usually at level of C₂-C₃ or C₃-C₄ vertebra, and injury to spinal cord and brainstem (pons and medulla).
• the dislocation of the atlanto occipital joint or the odontoid process of  the axis vertebra causes pulping of the spinal cord and transaction of the cervical cord. There even can be rupture of the brain stem with proper judicial hanging.
• Postmortem hanging:  Sometimes the victim may be murdered by some other means  and then hanged postmortem in order to mislead the police. thorough and meticulous postmortem examination, the original cause of death can also be established.

Don’t Forget to Solve all the previous Year Question asked on Hanging: Postmortem findings,Strangulation,Medico-legal aspects of hanging.