Ligature Strangulation Research Articles

A ritual murder shaped the Early and Middle Neolithic across Central and Southern Europe.

In the Rhône Valley's Middle Neolithic gathering site of Saint-Paul-Trois-Châteaux (France), the positioning of two females within a structure aligned with the solstices is atypical. Their placement (back and prone) under the overhang of a silo in front of a third in a central position suggests a ritualized form of homicidal ligature strangulation. The first occurrence dates back to the Mesolithic, and it is from the Early Neolithic of Central Europe that the practice expands, becoming a sacrificial rite associated with an agricultural context in the Middle Neolithic. Examining 20 cases from 14 sites spanning nearly two millennia from Eastern Europe to Catalonia reveals the evolution of this ritual murder practice.

Significance of Contusion at the Vocal Cord and Perivocal Cord Area in Cases of Non-intubated Death.

Every finding during a neck autopsy may be essential for accurately diagnosing and explaining the mechanism of death. In this prospective study in the Department of Forensic Medicine and Toxicology of Jordan University Hospital, 17 out of 95 neck autopsies revealed contusions of the laryngeal mucosa in the vocal or perivocal area. These contusions were found to be associated with various causes of death, including mechanical asphyxia (such as throttling, ligature strangulation, hanging, smothering, choking, plastic bag asphyxia, gagging, and inhalation of blood) and other causes (such as atypical drowning, carbon monoxide poisoning, head injury due to a road traffic accident, burns, electrocution, and brain edema). This study provides insight into the mechanisms of this important lesion and may contribute to a better understanding of the cause of death.

Cable ties in forensic practice.

Cable or zip ties are mass produced inexpensive nylon fasteners, which have a locking mechanism to prevent them from being loosened. Their use in medicolegal cases is infrequent, being involved in situations of neck compression or restraint. The Forensic Science SA Pathology Database (in Adelaide, Australia) and search engines PubMed, Google Scholar and Google were examined for cases where cable ties were documented as either causing death or being potentially lethal, being a contributor to death, or having been used for restraint purposes. Neck compression resulting in ligature strangulation was found in cases of homicide and suicide in adults. Accidental neck compression was rarely reported in children. Cases of restraint again occurred in both homicides and suicides, with nonlethal wrist restraint being used by law enforcement officers in lieu of traditional handcuffs. Cable ties may also be used to fasten ligatures to suspension points in case of hanging. Despite their ready availability, cable ties are only relatively rarely involved in medicolegal cases. More traditional forms of manual or ligature neck compression are still favoured possibly because they require less dexterity.

Incomplete decapitation in suicidal vehicle-assisted ligature strangulation: A case report and a review of the literature

Vehicle-assisted ligature strangulation is an extremely rare suicide method. We report a case of a 43-year-old man who secured one end of a nylon rope to a tree and the other end around his neck, then got inside his vehicle and stepped on the gas, leading to an incomplete decapitation. A sharply demarcated encircling ligature mark was found upon external examination, along with a deep laceration in the anterior region of the neck. The severance plane passed between the third and fourth cervical vertebrae, with diffuse haemorrhagic infiltration of the cervical muscles, in accordance with autopsy findings reported in the literature. The lung histological examination described a large amount of red blood cells and pulmonary oedema. A review of the literature concerning suicidal vehicle-assisted ligature strangulation cases allowed us to investigate some common autopsy findings, as well as the rope features relevant to the beheading.

Reconstruction of Trauma Dynamics Due to Ligature Strangulation by Using a Dynamometer: A Technical Report.

Asphyxiation caused by violence, particularly through ligature strangulation, necessitates the application of a force that is characterized by a point of application, direction, and intensity. These properties can be quantified through the use of a dynamometer, which is composed of a graduated scale and a spring. In this particular study, an experimental model utilizing a dynamometer was employed to aid in the diagnosis and analysis of the dynamics of violent trauma resulting from homicidal ligature strangulation. The experimental model was applied to an attempted murder case involving strangulation. The primary challenge in this case was to establish the attempted murder scientifically, as the offender claimed that there had been no intent to kill, but instead an attempt to frighten the victim. To prove his assertion, the assailant emphasized the absence of strangulation injuries on the victim's neck. To investigate, a crane scale dynamometer was fixed on a cable and placed on a manikin's neck. The potential measurable combinations with the dynamometer were then compared to witness accounts and the injuries found on the victim. The utilization of a dynamometer in our case permitted the diagnosis and verification of a trauma that was undoubtedly caused by violent asphyxiation via strangulation. The information yielded by the dynamometer was subsequently submitted as scientific evidence in Court, serving to substantiate the intent to commit homicide and substantiate the credibility of the victim's testimony.

A clandestine affair – A case report

According to the witnesses, crime scene and inquest report, deceased is a 30 years old female, found dead lying on floor, in her apartment house along with a male, who was found hanging from a ceiling fan in the same room. The deceased body was brought to Mortuary, Osmania General Hospital at 04:00 PM on 28/01/2023 by the Investigation Officer and requested for postmortem examination under section 174 Criminal Procedure Code. The postmortem findings were an antemortem horizontally placed ligature mark at the level of thyroid cartilage in the front of neck, internally there was an inward fracture of tip of greater horn of hyoid bone on the right side with surrounding tissue contusion. There were some small crescent shaped abrasions noted on both sides of front of neck which were suggestive of nail marks. There was a contusion over the inner surface of the scalp. With meticulous crime scene investigation and post mortem examination and interpretation of the findings cause of death was given as “Ligature Strangulation”

An uncommon case of self-strangulation by ligature and the importance of a crime scene visit by a forensic pathologist

Self-strangulation is an uncommon method of suicide. The body was found lying on the floor in front of the "multi-gym" inside the gym in the basement of the deceased's house. It was initially presented as a case of sudden death, but during autopsy, a ligature mark was noted over the deceased's neck and bilateral temporal regions along with findings supportive of ligature strangulation. A visit was made to the crime scene. A plausible reconstruction of events suggested that the deceased had used the metallic rope of the multi-gym for this purpose. The rope was connected to weights from one end, passed through a pulley and connected to a rod at the other end. Its width and pattern matched with the ligature mark. The deceased wound the rod end of the rope around his neck and entangled the rod to the rope over his head so that the weight attached to the other end tightened the rope around his neck and strangled him. As the rope unravelled, gravity caused the body to fall to the ground while the rope with the rod resumed its normal position due to the pull of the weight attached at the opposite end. This case is reported for its rarity and the unusual means used to commit suicide by self-strangulation.

Hyoid Bone Fractures in Mechanical Asphyxiation Deaths: A Study at Osmania General Hospital, Hyderabad, India

The fractures of the hyoid bone in the neck are one of the important indicators of any pressure over the neck. Thepresent study includes a huge sample size of mechanical asphyxiation deaths (791 cases) to study the incidence ofhyoid bone fractures in hanging, ligature strangulation, and throttling. Fractures of the hyoid bone were noticed ina total of 12 cases, 9 male and 3 female with 33.33% incidence in the 41-50 years age group. Throttling dominatedthe strangulation group in our study with a share of 42.85%. A total of 6 (5 male, 1 female) cases showed hyoidbone fractures in the strangulation group wherein the predominant incidence is seen in 41-50 years(50%). In ourstudy, right cornu fractures are frequent in hanging and throttling. Except for one outward compression fracturein a hanging instance, all of the fractures identified in our investigation are inward compression fractures. Thepresent study adds to the existing literature that hyoid bone fractures are less common in hanging than throttlingand any fracture of hyoid bone is common after the age of 40 years because of calcification.

Diagnosis of Hanging in an Alleged Case of Ligature Strangulation: A Case Report

Hanging is one of the commonest method among the painless suicidal deaths. In few instances, false allegations are made by next of kin and they claim that the ligature mark over the neck of deceased is due to strangulation or postmortem hanging rather than ante-mortem hanging. Vice versa cases are also likely in an attempt to concealment of the crime. In such cases, complete post-mortem examination and incident scene visit are very helpful to differentiate between the two. In the case being reported, the authors report a case of young adult female individual in which ligature strangulation was alleged by the parents and investigating officer but which was diagnosed as a hanging after autopsy. Authors also report the important external as well as internal findings in a case of hanging and discuss the unusual complications lead to death after hanging.

An overview of suicides related to motor vehicles.

Although vehicles may be used in a wide variety of suicides, this has not been a focus in the forensic literature. Thus, an analysis of coronial autopsy reports at Forensic Science SA, Adelaide, South Australia over a 16-year period from January 2005 to December 2020 was undertaken to provide an overview of cases in which it was considered that a vehicle had been integral to the successful completion of a suicide. De-identified details were collected from all cases in which a vehicle had facilitated or been used as a method of suicide. A number of different types of vehicle-related suicide methods were identified, including cases where vehicles had been used as secure places for suicide or where the vehicle had been used to cause significant blunt force trauma or to enter a lethal environment such as water. Specific examples were taken from the following categories: (1) inhalation of gas, (2) drug toxicity, (3) hanging or ligature strangulation, (4) self-immolation, (5) drowning, (6) vehicle collision, (7) driving off a cliff, (8) jumping or lying in front of a vehicle and (9) the use of more than one method (i.e. complex). This report is not intended to provide an epidemiological analysis of car-related suicides. Instead, the details of selected cases have been used to illustrate the spectrum of methods that may be used in vehicle-assisted suicides.

A rare case of ligature strangulation using a dental unit: Distinguishing suicide from homicide in a death scene investigation

Ligature strangulation is more common in homicides and is rarely seen in suicides and sexual asphyxia involving neck compression. We report a rare case of a dentist found dead of ligature strangulation next to a dental unit. The ligature was attached to the window frame, wrapped tightly around the neck once with a noose, and tied at the midpoint of the neck and at the head of the dental chair. A death scene and medicolegal investigation suggested suicidal ligature strangulation. The victim was squatting next to the dental unit with the control panel within reach. Pressing Button 1 (the recline button) would have tightened the ligature around the neck. A container containing pink nylon ribbon was found near the victim. The position of the knot at the front of the neck was consistent with suicide. Bloodstain pattern analysis confirmed the longitudinal flow pattern. No other remarkable findings were observed. Nobody had visited the clinic, autopsy found no drugs in his system, and the environment was undisturbed. Homicide was ruled out. According to witnesses, the victim had been in litigation with the owner of the building where his clinic was located. There were no reports of the victim having engaged in any unusual sexual or autoerotic activity. He had not received any death threats. Approximately 1 h before his death, he sent a suicide text message to his wife. Our case highlights the importance of distinguishing between suicide and homicide, especially in cases of ligature strangulation.

Ligature strangulation in 2001–2020 in the materials of the Jagiellonian University Department of Forensic Medicine, Kraków

Aim: The aim of the study was to analyze and compare the most common post-mortem changes which can be found in the body after ligature strangulation and compare it with the most recent literature. Materials and methods: autopsy protocols from years 2001–2020 gathered in the Department of Forensic Medicine in Kraków were investigated. 37 cases of certain and possible strangulation were found and analysed. Prevalence of ligature strangulation, age, sex, information concerning perpetrator and post-mortem changes were considered. Results: we found and analysed 37 cases, however only in 16 cases the certain cause of death was ligature strangulation. in the remaining 18 cases the mechanism of death was not precisely defined. in 3 cases advanced late post-mortem changes disturbed establishment of certain identification. Women constituted 87.5% of all victims, while men 12.5%. among 16 certain ligature strangulations we analysed the most important post-mortem changes. Both subconjunctival hemorrhagic petechiae and facial skin petechiae were observed in 93.8% of the cases, laryngeal or hyoid fracture in 56.3%, and hemorrhages in neck muscles were detected in 87.5% of the cases. Conclusions: The most frequent post-mortem changes after ligature strangulation include subconjunctival petechiae, facial skin petechiae and hemorrhages in the neck muscles which are convergent with the data found in literature. The autopsy may not indicate the circumstance of strangulation.

Asphyxia homicides in Denmark 1992-2016.

In this retrospective study , we present the findings in 250 homicides by asphyxia in Denmark in a 25-year period, with a particular focus on the autopsy findings in strangulation. Our intention is for the results to be used in future death investigations, where difficulties in interpretation of findings in potential asphyxial deaths arise. Asphyxia homicides showed a strong bias with respect to sex, age, and homicide type. The frequent female victim was typically an adult, whereas the rarer male victim was most often a child. Female offenders most often killed their children, and male offenders most often killed their female partner. Generally, most asphyxia homicides took place in a domestic setting. Manual strangulation and ligature strangulation were the most common mechanisms of asphyxia homicides (81.6%). A lack of petechial hemorrhages, especially in the conjunctiva, was rare in homicidal strangulation, but there were exceptions, especially when there was postmortem decomposition, making it impossible to verify them. Most victims of strangulation had skin lesions in the face (including the jawline) or on the neck, with accompanying hemorrhages in muscle and connective tissue, but the findings could be subtle or compounded by decomposition. Fractures of the laryngo-hyoid complex were common in strangulation, particularly in manual strangulation (chi-sq = 4.0993, df = 1, P < 0.05) and were clearly related to the age of the victim (chi-sq = 82.193, df = 4, P < 0.001). In children and young adults dying from homicidal strangulation, a lack of fractures is to be expected, while a lack of fractures is unusual, but not entirely unexpected, for adults and aged people.

Histological examination of carotid artery tissue in cases of ligature strangulation and hanging

Violence against the neck can result in a range of macromorphological and micromorphological findings. However, the forensic relevance of the carotid sinus in cases of violence against the neck remains controversial. In this follow-up study of 22 cases of suicidal and accidental strangulations, carotid bifurcations were examined histologically for morphological changes implying direct trauma, including haemorrhage and immunohistochemical expression of heat-shock proteins 27, 60, and 70 and aquaporin-3. These cases were compared with a control group (82 cases) without neck compression or head trauma and with variable causes of death. No relevant histopathological findings implying direct trauma of the carotid bifurcation were found. No cases showed positive aquaporin-3 staining and only five cases showed positive heat-shock protein-27 staining, all of which were hangings. Without massive trauma of the carotid bifurcation, histological alterations cannot be expected. Without signs of rapid death, findings of acute circulatory failure, macromorphological and micromorphological findings of neck compression, and reliable markers indicating relevant impact on the carotid bifurcation the diagnosis of a lethal reflex cannot be verified. Key points Among 22 cases of strangulation causing death, there were 16 cases of hanging and 6 cases of ligature strangulation Few cases showed small haemorrhages located predominantly in the surrounding fat and connective tissues; however, the haemorrhages did not have any effects on the tissues Neck compression had minimal effects on heat shock protein 27 expression in carotid artery tissue Aquaporin-3 staining suggested it is not a useful marker for relevant neck pressure, or that there had not been any relevant neck impact Our findings suggested no direct evidence for reflex cardiac death resulting from a brief force against the neck

A comparative analysis of pattern of homicidal deaths among males and females in a district of West Bengal

An observational, cross-sectional study was undertaken among all cases of unlawful homicidal deaths during one year in Malda district of West Bengal to find out the pattern of homicidal deaths, to compare the differences between male and female homicidal deaths and also to find any relationship with social and demographic factors. It was found that most of the female victims are in reproductive age-group and they were most commonly killed by manual and ligature strangulation whereas the male victims of homicide were mostly in economically productive age group and they were most commonly killed by mechanical injuries like incised wound, penetrating wound, head injury and gunshot injuries. The difference between males and females regarding cause of death was significant. The antecedent history of illicit sexual relations leading to homicide was significantly more among females. It was also seen that illicit sexual behaviour led to homicide in most of the unmarried or divorced female victims whereas in case of married woman, illicit sexual behaviour of the husband led to homicide of that woman in about fifty percent of the cases. Disputes regarding money or property was the major antecedent history among male homicide victims. So awareness should be built-up among unmarried, separated and divorced woman against illicit sexual relationship. Adult and earning male members of the family should be cautioned about debt traps and also should be made aware about procedures of legal action to be taken in case of property dispute with relatives and neighbours.

Vascular injury is an infrequent finding following non-fatal strangulation in two Australian trauma centres.

Non-fatal strangulation assessment is challenging for clinicians as clear guidelines for evaluation are limited. The prevalence of non-fatal strangulation events, clinical findings, frequency of injury on computed tomography angiogram (CTA) and outcomes across two trauma centres will be used to improve this assessment process. This is a retrospective observational study of adult presentations during 2-year period to two major-trauma referral hospitals and subsequent 12 months to identify delayed vascular injury. Patients included using standardised search terms. Demographic data, clinical findings, radiological reports and outcomes were included for review. A total of 425 patients were included for analysis. Self-inflicted injury comprised 62.1%, with domestic violence (28.5%) and assault (9.4%) the remainder. Manual strangulation events 36.7% of overall presentations and 63.3% following ligature strangulation (ligature strangulation, incomplete and complete hanging). On examination soft signs present in 133 (31.2%) cases, commonly neck tenderness in isolation. No hard signs suggesting vascular damage. Vascular injury was demonstrated in three cases (0.7% of the total cohort and 1.5% of CTA scans completed), and all occurred in ligature strangulation events as a result of hanging. No patients had delayed vascular injury in the 12-month period post-initial presentation. In non-fatal strangulation presentations, the majority have subtle signs of neck injury on examination with inconsistent documentation of findings. Low rate of vascular injury overall (0.7%), and entirely in hanging events. No longer-term vascular sequalae identified. Improving documentation focusing on hypoxic insult and evidence of airway trauma is warranted, rather than a reliance on computed tomography imaging to delineate a traumatic event in non-fatal strangulation.

English

Ligature strangulation is an important aspect of forensic practice and unless proven otherwise is considered to be a homicide. We report a case of a traveler, who was attending a political procession, but was later robbed and strangulated with a scarf by some anti-social elements. His body was subsequently abandoned in the wilderness to get decomposed leading to the diminution of valuable traumatic signatures over the neck, thereby presumably raising difficulties in diagnosis of cause and manner of death. After the body was recovered, a careful autopsy was conducted on it with fruitful results. The cause of death was opined to be homicidal ligature strangulation. Therefore, thorough assessment and proper documentation of strangulation injuries, even in highly decomposed corpses, may lead to smooth execution of justice. Key words: Decomposition, ligature strangulation, hyoid bone fracture, garroting.

Unanticipated Ligature Strangulation: A Case Report

Strangulation is a form of mechanical asphyxia by compression of the neck with an outside force either bya ligature or hands, in which a constricting force other than the weight of the body is directly applied.Suchdeaths are generally considered homicidal. Here we present a case of 60year old female, who got trapped inthe rice huller machine with the saree she was wearing and accidentally got strangled.

Microscopic analysis of compression injury over neck: One-year prospective study

The present study was conducted in Department of Forensic Medicine and Toxicology of a Government Medical College and Hospital in year 2017. Total 2781 postmortem examinations were conducted in 2017. Out of that total 2781 cases, 176 compression of neck cases came for postmortem and amongst these 105 cases were studied in detail as per inclusion criteria. Out of 105 cases of compression around neck, which were studied, there were 93 cases of hanging, 10 cases of ligature strangulation, 01 case of manual strangulation and 01 case of accidental strangulation studied. On gross in total 11 cases of strangulation hemorrhage in subcutaneous tissue, strap muscle and sternocleidomastoid muscle observed and in only 20 cases of hanging there was hemorrhage observed in subcutaneous tissue and no hemorrhage observed in strap and sternocleidomastoid muscle in hanging cases. In this present study on histopathology vascular congestion and extravasation of red blood cells observed in 28 cases of compression of neck. These findings indicate the importance of histopathology of underlying neck structure in neck compression cases in documenting antemortem nature of hanging and strangulation in doubtful cases.

Muscular Hemorrhages Around the Scapula Provide Insight on the Manner of Asphyxia: A Preliminary Study.

Muscular hemorrhages around the scapula that are caused by upper extremity motion are rarely reported in cases other than drowning. We examined differences in the frequency of muscular hemorrhages around the scapula and stratified them by the cause of death. Muscular hemorrhages were mostly noted in cases of drowning (118/185, 63.8%), followed by cases of asphyxia (23/44, 52.3%). In addition, muscular hemorrhages around the scapula were found in cases of ligature strangulation (8/11, 72.7%), manual strangulation (2/3, 66.7%), choking (11/14, 78.6%), and traumatic asphyxia (2/2, 100%). Muscular hemorrhages were not found in cases of hanging or environmental suffocation, possibly because of the short time interval preceding the loss of consciousness. The distribution of muscular hemorrhages was similar in choking and drowning cases. Muscular hemorrhages due to strangulation were mainly unilateral, whereas those due to choking and drowning were mainly bilateral. During all types of asphyxia, muscular hemorrhages around the scapula were considered to be the result of conscious, active upper extremity motion. Because the frequency and laterality of muscular hemorrhages around the scapula differed based on the type of asphyxia, our findings provide insights into the manner of asphyxia that could be used to aid in the identification of homicidal hangings.