Strangulation Cases Research Articles

Factors Associated With Legal Decisions of Nonfatal Strangulation Cases With Forensic Evidence

This study examines the influence of offender, victim, and case characteristics along with available forensic evidence on legal outcomes of nonfatal strangulation (NFS) cases. Research points to the importance of NFS forensic evidence collection to corroborate the attack during legal proceedings. However, little is known regarding the factors associated with legal decisions for NFS cases with forensic evidence. Law enforcement reports, forensic medical examinations, and legal outcomes for 63 NFS cases in Florida were analyzed. Findings have implications for the criminal justice system, as forensic medical exams can be used to collect valuable evidence to support prosecution outcomes.

Enhancing Forensic Diagnostics: Structured Reporting of Post-Mortem CT versus Autopsy for Laryngohyoid Complex Fractures in Strangulation.

The purpose of this study was to establish a standardized structured workflow to compare findings from high-resolution, optimized reconstructions from post-mortem computed tomography (pmCT) with autopsy results in the detection of fractures of the laryngohyoid complex in strangulation victims. Forty-two strangulation cases were selected, and pmCT scans of the laryngohyoid complex were obtained. Both pmCT scans and autopsy reports were analyzed using a structured template and compared using Cohen's kappa coefficient (κ) and the McNemar test. The study also compared the prevalence of ossa sesamoidea and non-fusion of the major and minor horns of the hyoid bone between both diagnostic methods. The detection of fractures showed a very good correlation between autopsy and pmCT results (κ = 0.905), with the McNemar test showing no statistically significant difference between the two methods. PmCT identified 28 sesamoid bones, 45 non-fusions of the major horns, and 47 non-fusions of the minor horns of the hyoid bone, compared to four, six, and zero, respectively, identified by autopsy (p < 0.0001). Autopsy and pmCT findings correlate well and can be used in a complementary manner. PmCT is superior to autopsy in identifying dislocations and detecting anatomical variations in the laryngohyoid complex, which can lead to misinterpretations during autopsy. Therefore, we do not advocate replacing autopsy with pmCT but propose using a structured workflow, including our standardized reporting template, for evaluating lesions in the laryngohyoid complex.

Prevalence of secondary brain injuries and association with trauma circumstances in neuropathologically examined medico-legal autopsy cases with primary head trauma

Primary head injury is often followed by secondary brain damage. However, the association between injury circumstances and the prevalence of secondary injuries remains unclear. We report the prevalence and association of secondary brain injuries with the circumstances in which a head injury was sustained. The sample comprised 76 neuropathologically examined medico-legal autopsy cases with an acute primary head injury. Neuropathology reports were analysed to determine the prevalence of various secondary injuries, i.e., hypoxic-ischaemic neuronal injury, brain oedema, and vascular axonal injury (VAI). The prevalences were compared between cases from three distinct injury circumstances, i.e., fall, assault, and strangulation. The sample had a median age of 49 years (interquartile range 27–73) and 71.1% were identified as male. As for distinct injury circumstances, the sample comprised 14 fall cases, 21 assault victims, and 6 strangulation victims. The prevalence of hypoxic-ischaemic neuronal injury was highest in strangulations (100.0%), followed by assaults (81.0%) and falls (64.3%); of specific brain regions, statistically significant differences between the three case groups were found in frontal and parietal cortex (p ≤ 0.018) and the hippocampus (p = 0.005). Brain oedema was present in approximately half of assault (47.6%) and strangulation cases (50.0%), contrastingly to the lower prevalence in falls (7.1%; p = 0.024). The prevalence of VAI appeared higher among assault (23.8%) and strangulation cases (16.7%) compared to falls (7.1%), but the differences were not statistically significant. We conclude that hypoxic-ischaemic neuronal injury and brain oedema were more prevalent among assault and strangulation cases compared to falls.

Innovative techniques in the treatment of penile strangulation: a case report

Introduction and importance: Penile strangulation is a medical emergency characterized by the encirclement of the penis by an external object, resulting in circulatory compromise. Case presentation: A 35-year-old male presented with penile pain and urinary obstruction due to the inability to remove the ring. Upon examination, the ring was firmly lodged at the base of the penis, causing significant swelling and discoloration in the distal region. Interventions and outcomes: Initial attempts to cut the ring using standard tools were unsuccessful, leading to the engagement of a rescue team equipped with an air cutter. The cutting procedure, complicated by the ring’s thickness and hardness and the significant edema, took ~90 min. Safety measures, including the use of a surgical brain spatula and forceps, were employed to protect the penile skin from damage during the operation. Relevance and impact: This case underscores the necessity for timely intervention in penile strangulation cases and highlights the effectiveness of collaboration with specialized rescue teams equipped with appropriate cutting tools. It also emphasizes the importance of safety considerations when employing nonmedical devices in medical emergencies. The patient experienced a favorable outcome, with significant improvement in swelling and discoloration postprocedure, and no complications during follow-up. This report contributes to the limited but crucial literature on managing penile strangulation, particularly regarding the methods and timeframes for safely removing constricting objects.

Prosecuting strangulation offences: understanding complainant withdrawal using a social entrapment lens

ABSTRACT In many countries, one of the central challenges to the successful prosecution of domestic violence offences is the complainant’s disengagement from the prosecution process. Withdrawal is particularly likely in cases of serious domestic violence with limited physical evidence, such as strangulation. Recently countries including England and Wales and Australian jurisdictions have introduced discrete offences of strangulation, a behaviour commonly associated with domestic violence and coercive control, that is extremely risky and dangerous. In this paper, we aim to build on our understanding of complainant withdrawal in strangulation cases. Drawing on a sample of strangulation offence prosecution casefiles in Queensland, Australia we examine five casefiles using a social entrapment lens. We argue that using this lens improves understanding of the factual context in which complainants withdraw their support for prosecution and may have implications for prosecution practice.

Longitudinal visibility of MRI findings in living victims of strangulation

Initial experiences with magnetic resonance imaging (MRI) of living strangulation victims demonstrated additional findings of internal injuries compared to the standard clinical forensic examination. However, existing studies on the use of MRI for this purpose mostly focused on the first 48 h after the incident. The aims of this study were (a) to evaluate the longitudinal visibility of MRI findings after violence against the neck by performing two MRI examinations within 12 days and a minimum of four days between both MRI scans and (b) to assess which MRI sequences were most helpful for the detection of injuries. Twenty strangulation victims participated in this study and underwent one (n = 8) or two (n = 12) MRI scans. The first MRI examination was conducted during the first five days, the second five to 12 days after the incident. Two blinded radiologists assessed the MRI data and looked for lesions in the structures of the neck. In total, 140 findings were reported in the 32 MRI examinations. Most of the findings were detected in the thyroid and the muscles of the neck. T2-weighted SPACE with fat suppression, T1-weighted TSE and T1-weighted MPRAGE were rated as the most helpful MRI sequences. Subjects who showed findings in the initial scan also demonstrated comparable results in the second scan, which was performed on average 8.4 days after the incident. Our results show that even up to 12 days after the incident, the criminal proceeding of strangulation cases may greatly profit from the information provided by an MRI examination of the neck in addition to the standard clinical forensic examination.

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.

Vehicle-assisted ligature decapitation - an unusual case report.

Suicide by vehicle-assisted strangulation resulting in decapitation is a rare occurrence, characterized by a high kinetic energy mechanism that produces a clean-cut appearance in the decapitation area. Often resembling an incisive wound, this particular finding can mislead local authorities into investigating the case as a homicide. This case report describes an adult male who accelerated his vehicle after tying a nylon rope around his neck and securing it to a metallic structure on the wall. Furthermore, we conducted a brief review of cases published within the last ten years, summarizing the most prevalent findings associated with these incidents. By analyzing previously reported cases alongside our own, we aim to consolidate the prevailing patterns observed in vehicle-assisted strangulation cases. This underscores the paramount importance of thorough scene analysis by the medico-legal team and emphasizes the significance of subsequent necropsy findings in accurately discerning the manner of death.

The Socio-Demographic Profile of Unnatural Death in Bihar

Background- Unnatural deaths place a significant burden on society. The sociodemographic characteristics of these deaths in Bihar is not well-documented in the literature. The goal of the current study was to add to knowledge so that these deaths could be stopped or reduced. Material and Method- A retrospective autopsy analysis of one-year unnatural deaths (421 cases) was done at the Department of Forensic Medicine and Toxicology, Nalanda Medical College &amp; Hospital, Patna &amp; Madhubani Medical College &amp; Hospital, Madhubani, Bihar. RTA was the most common cause of unnatural deaths (126/421 i.e., 29.9%). It was followed by violence death (84/421 i.e., 19.9%), poisoning (74/421 i.e., 17.6%), hanging (34/421 i.e., 8.1%), burn (32/421 i.e., 7.6%), drowning (27/421 i.e., 6.4%), strangulation (20/421 i.e., 4.8%) and others (electrocution, lightning, fall- 24/421 i.e., 5.7%). Victims of most unnatural deaths were male except in burn and strangulation cases (3.5% vs 4.1% &amp; 2.1% vs 2.6%). Cases of unnatural deaths were seen to be higher in younger and working age groups (226/421 i.e., 53.4%) in both males and females in the age group of 16-40 years. There was a slight increase in unnatural deaths in the summer season (40%). Suicide was the most common cause of unnatural deaths (140/421 i.e., 33.2%), followed by RTA (126/421 i.e., 29.9%), homicide (104/421 i.e., 24.7%), and other causes (drowning, electrocution, etc.– 51/421 i.e., 12.2%). Male to female death ratio in suicide, homicide and RTA was 1.7 (88/52), 4.8 (86/18), and 8.6 (113/13) respectively. Conclusion- Unnatural death is one of the indicators of the level of social and mental health. Many studies showed different results regarding different modes of unnatural death. These deaths can be minimized by public awareness, skilled drivers, better road conditions and health system, female education and their social empowerment, sincere effort to solve unemployment, strict rules of law, and regulation on the selling of agrochemicals and other poisons.

Usage areas of microrna (miRNA) in forensic genetics

Interest in molecular based techniques increases in every field of forensic sciences. Use of microRNAs (miRNA) in forensic genetics is one of them. The aim of this article is giving a brief information about microRNAs and their use in forensic genetic applications. MicroRNAs are small noncoding RNAs and because of their important features such as tissue-specificity and high stability in specific conditions, they are used in various studies for forensic purposes. In the article, usage areas of miRNAs and promising results obtained from these studies are mentioned. Body fluid identification, organ tissue identification, determination of stain age, wound age determination, post mortem interval (PMI) identification, age estimation of an individual, lesion assessment in strangulation cases, identification of brain damage and determination the abuse of anabolic androgenic steroids are the subjects which potential use miRNA are examined. The limitations of miRNAs in the forensic genetics applications are also mentioned in the article.

Modeling one-handed grip strangulation: Intentionality of the gesture and age influence.

Strangulation is a violent act which can be lethal and is often studied in forensic context. The neck includes several anatomical elements that can evolve with aging. We therefore created a numerical human neck model including the main anatomical elements and simulated one-handed grip strangulation cases. In addition, we created 3 models each representing age groups: 20-30years old, 30-50years old and over 50years old. The main changes between the different age groups are the ossification of the cartilages and the muscles mechanical properties. Several initial and boundary conditions have been tested to perform a realistic simulation of one-handed grip strangulation. Stress analysis and fracture observation were compared with the grip strength of an average man, 552N, to look at the intentionality of the gesture. In each age group, the results show no model fracture for a force of 552N. It is necessary to reach a minimum of 1406N before observing a first fracture on the hyoid bone. However, it is possible to get stresses on the hyoid bone and on the thyroid cartilage way before 552N. It thus appears that the force created by one-handed grip strangulation is not sufficient to cause fractures of the bony elements of the neck, but it remains sufficient to compress the larynx and at least reduce airflow.

Policing nonfatal strangulation within the context of intimate partner violence

PurposeThe current study examined police response, specifically identification and arrest decisions, to nonfatal strangulation occurring within the context of intimate partner violence.Design/methodology/approachData for the present study were derived from a sample of 117 possible nonfatal strangulation case reported to a police agency located in one of the fifth largest and most diverse US cities. A series of logistic regression models were employed to examine the role of victim, suspect and case characteristics on officer formal identification of strangulation and officer arrest decisions.FindingsResults revealed that 14% of all intimate partner violence (IPV) cases reported to the police agency involved possible nonfatal strangulation and less than half of all possible nonfatal strangulation cases were formally identified as such by officers. The odds of formal identification of strangulation by police increased when strangulation was manual and when victims reported difficulty breathing. Injury and formal identification increased the odds of arrest.Originality/valueThis study is the first to examine predictors of police formal identification and arrest decisions in nonfatal strangulation occurring within intimate partner violence incidents.

A study of demographic variables of violent asphyxial deaths in Agra region

Introduction: In our world, many human lives are lost to crime and violence in which asphyxial deaths are one of the major contributors. Materials and Methods: In present study analysis of 391 deaths caused by asphyxia out of 3224 autopsies conducted in mortuary of S. N. Medical College, Agra during period of 1½ years from March 2015 to August 2016 is conducted. Data obtained is reviewed and analyzed according to different types of asphyxial deaths, their age wise distribution, sex wise distribution, manner of death and contributing factors. Results: Proportion of asphyxial deaths was 12.1% (391 cases). Hanging (64.9%) is most commonly encountered followed by drowning (24.8%) and strangulation (4.6%). Most common victims are male with male: female ratio of 1.37: 1. Most cases falls in 21-30 years age group with 27.4% of total. Majority of hanging cases were suicidal while all strangulation cases were homicidal. Majority of drowning cases were accidental. It was elicited from history that personal reasons like failure in examinations, psychiatric problems, long time illness etc. were the most common reasons for suicide by hanging. Conclusion: In present study, suicidal hanging and accidental drowning seems to be major proportions of violent asphyxial deaths. Both these manners of deaths indicate frustration and carelessness on part of population which are preventable and needs to be rectified on urgent basis. Keywords: Asphyxia, Hanging, Strangulation, Drowning.

Prosecutorial Response to Nonfatal Strangulation in Domestic Violence Cases.

Recent research has pointed to the need for systematic law enforcement training on domestic violence when nonfatal strangulation is involved to improve evidence-based prosecution of these potentially deadly assaults; however, virtually no research has examined the legal response to nonfatal strangulation since many states have made it a separate criminal felony. The current exploratory study examines filing, charging, and adjudication decisions of nonfatal strangulation cases over a 3-year period based on evidence documentation in law enforcement reports to explore how these cases are handled by the criminal justice system in Brevard County, Florida. Results support previous research showing the importance of training police officers and other personnel as insufficient evidence may be one possible factor limiting the prosecutors' ability to successfully prosecute domestic violence strangulation offenders to the highest extent available under the law. Implications spread across multiple disciplines.

Postmortem Magnetic Resonance Imaging and Postmortem Computed Tomography in Ligature and Manual Strangulation.

The aim of this study was to evaluate magnetic resonance imaging (MRI) findings in cases of fatal manual or ligature strangulation. Verification of strangulation by computed tomography (CT), MRI, and at autopsy as well as its detectability in each modality was assessed. We retrospectively analyzed 6 manual and ligature strangulation cases between 2013 and 2019 who all underwent a whole-body CT, head and neck MRI, and an autopsy. Two radiologists examined head and neck imaging data and compared the data to autopsy findings. Magnetic resonance imaging showed a high efficiency in verifying intramuscular hemorrhages, which were confirmed in autopsy. Moreover, in one case without a visible strangulation mark, soft tissue injuries associated with strangulation were detected. Fractures, especially thyroid cartilage fractures, were successfully diagnosed by CT. As MRI showed a successful detection of soft tissue lesions in relation to strangulation, it can serve as an alternative method or provide additional value to an autopsy. Intramuscular hemorrhages are a common finding in manual and ligature strangulation, providing a useful sign of applied pressure on the neck. However, to evaluate fractures, an additional CT or autopsy is recommended.

Retrospective Analysis of 73 Hanging and Ligature Strangulation Cases.

Objective To retrospectively analyze 40 cases of hanging and 33 cases of ligature strangulation in Kunming, to explore the neck injury characteristics and similarities and differences of related asphyxia signs of corpses in hanging and ligature strangulation cases, in order to provide reference for forensic identification. Methods Statistics of hanging and ligature strangulation cases accepted by Kunming Municipal Public Security Bureau from 2000 to 2017 were collected. Data including the gender, age, injury tool, neck injury and related asphyxia signs of the deceased in hanging and ligature strangulation cases were statistically tested by SPSS 23.0. Results There were more males in hanging cases than females. However, there were more females than males in ligature strangulation cases. In hanging cases, suicide was common, while homicide was rare. In ligature strangulation cases, homicide was common, while suicide or accidental death was rare. The average age of the deceased in hanging cases were older than those in ligature strangulation cases. The ligature mark in hanging was usually above the thyroid cartilage. The ligature mark in ligature strangulation was usually at the same level of the thyroid cartilage. The most common vital reactions were exfoliation and subcutaneous hemorrhage at the ligature mark, common among the deceased in hanging cases. Hyoid fracture rate of the deceased in ligature strangulation cases was more common than those in hanging cases. Conclusion The gender, age distribution, position of ligature mark, detection rate of vital reactions at the ligature mark and hyoid fracture rate of the deceased can help distinguish hanging from ligature strangulation.

Autopsy findings in Fatal neck Compression cases at Western Regional Hospital, Pokhara, Nepal

Background: Violent asphyxial deaths chiefly include death due to hanging, strangulation, suffocation and drowning. Deaths resulting from hanging and ligature strangulation both show similar type of findings in which the ligature marks at the neck is very important characteristic finding. That’s why it is a challenge for forensic experts and needs thorough knowledge and experience to differentiate between them. Some of the typical autopsy findings help autopsy surgeon in such dilemma. Objective of Present study is about the external and internal autopsy findings in fatal neck compression cases specially focusing on hanging and ligature strangulation cases to differentiate and clear the dilemma in such cases.&#x0D; Materials and Methods: Current study was conducted among 103 corpses with compression of neck by ligature materials brought for autopsy examination at Mortuary of Forensic Medicine Department of Western Regional Hospital Pokhara from February2017 to January 2018.&#x0D; Conclusion: In fatal neck compression cases external autopsy findings like dribbling of saliva from angle of mouth, facial pallor, urine and fecal material discharge were common finding in 99 cases of hanging where as it was variable in ligature strangulation cases. Similarly fracture of hyoid bone and thyroid cartilage was found in hanging cases with age greater than 38 years but not in any ligature strangulation cases as an internal autopsy finding.

Biomechanical study of the thyroid cartilage: A model of bi-digital strangulation

The presence of fracture on neck elements is an indication of violence. Both the hyoid bone and the larynx can be damaged by a strangulation mechanism. Thyroid cartilage, more specifically, may present lesions in response to this mechanical stress. These lesions result in fractures at the bases of the horns of the thyroid cartilage.This study focuses on the thyroid cartilage behavior in cases of bi-digital strangulation, using an anthropometric and biomechanical approach. To develop a biomechanical model, we performed an anthropometric study taking into account 14 distances measurements as well as 3 measurements of angles. These measures allowed us to determine a significant sexual dimorphism between individuals. Then, we define 6 morphologies models, composed of 3 females and 3 males individuals. In order to visualize the ossification of the cartilage, each model has been tested with bone properties. Strangulation cases were simulated by applying an imposed velocity of 0.4m/s then 1m/s. We observed different behaviors of the thyroid cartilage according to the sex and the morphology.

A Comparative Study of Hanging and Strangulation Cases in Agra Region

A Comparative Study of Hanging and Strangulation Cases in Agra Region

Feature of Ligature Mark and Fractures in Hanging and Ligature Strangulation Cases in Ajmer Region Population of India

Human race is one of the most intellectual living creatures among the whole living world. Human race has the potential to think and act, but unfortunately humans have also by desire searched the way to end their own by adopting various ways of mechanical asphyxia which is most commonly encountered in medicolegal practice. Hanging is one of the most common method of suicide in India and around the world, other types of hanging are, homicidal hanging judicial hanging, autoerotic hanging. A study was conducted in the Department of Forensic Medicine & Toxicology at JLN Medical College, Ajmer for a period of one year i.e. from January 2009 to December 2010. During this period a total number of 105 cases were observed; of which 100 were of hanging and 05 cases of ligature strangulation. In the investigation 100 hanging cases reported in Ajmer region were studied for injuries to bones and cartridge of neck. In the study, hyoid bone (13%) and thyroid cartridge fracture (5%) were most commonly observed among male and female respectively, no case of larynx and trachea fracture was recorded.