Abstract
For the medicolegal evaluation of victims of survived strangulation, a neck-magnetic resonance imaging (MRI) can be performed for assessing lesions in the inner soft tissues (fat, muscles or lymph nodes, for example). In our institute, such MRI examinations have been performed for a test period of 4 years with the aim of evaluating the use of this tool by forensic pathologists and identifying medicolegal indicators for the performance of neck-MRI in surviving victims of strangulation. We retrospectively reviewed medicolegal reports from all victims examined during the test period. We extracted objective lesions (e.g. petechiae, bruising and abrasions) and reported clinical symptoms (e.g. vision disorder, dysphasia) from the reports. These findings were compared to those reported from the neck-MRI. In total, 112 victims were clinically examined after suspected strangulation. Eleven of these victims underwent an MRI examination of the neck. Eighty-four of the victims presented objective lesions during the clinical examination, with eight showing signs of both petechiae and bruising. Neck-MRI was performed in four of these eight victims and three of them showed lesions visible in MRI. Of 76 victims with bruising as the only objective finding, 66 victims described clinical symptoms. Of those 66 victims, seven were examined by MRI and two demonstrated lesions in MRI. When MRI was performed, relevant findings were detected in 45% of the cases. This leads to the suspicion that many more findings could have been detected in the other victims, if an MRI had been performed in those cases. Our results lead us to the conclusion that an MRI examination of victims of suspected strangulation is useful, and strict indications for its application should be established.
Highlights
In forensic medicine, the examination of victims of survived strangulation is an important medicolegal issue [1,2,3,4]
Two categories of data were extracted: 1) forensic data, extracted from the medicolegal reports compiled by forensic pathologists and 2) radiological data, extracted from the radiological reports on the neck-magnetic resonance imaging (MRI), performed by board-certified clinical radiologists who studied the existing literature on interpretation of neck-MRI in strangulation victims
The description of the subjective symptoms provided by victims were extracted and designated as clinical symptoms, which were categorized as vision disorders, voice disorders, dysphasia and muscular neck pain
Summary
In forensic medicine, the examination of victims of survived strangulation is an important medicolegal issue [1,2,3,4]. An external clinical examination has to be carried out with the aim of identifying and describing lesions such as the presence of petechial bleeding in the face and neck, bruising to the neck and/or skin abrasions Besides such objective signs, a detailed anamnesis of the victim seeks to search for clinical symptoms that are taken into account for the medicolegal evaluation of the case. Forensic pathologists can only rely on the scientific literature [5, 6] and their national forensic society and its recommendations to come to their final conclusion Such recommendations differ from one country to another; even for the most important forms of evidence (e.g. presence of petechial bleedings), there is no international consensus to declare whether an event was life-threatening or not [7, 8]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
