Characterization of Lesions in Hanging Deaths

Abstract:  Hanging is a common method of committing suicide and a routine task in medico‐legal autopsies. The hanging mark is the most relevant external sign and its characteristics are well known, but, for unknown reasons, there are major differences in reports on internal findings. We retrospectively studied 228 consecutive cases of hanging deaths. A complete standard autopsy was performed for every case. We investigated the association between the characteristics of the hanging mark and the frequency of bone, cartilage, soft tissue, and vascular injuries with the mode of suspension. Most cases (75.3%) presented some kind of bone or cartilage fracture, but these were unrelated to any of the variables studied. Vascular lesions are clearly more infrequent: intimal injuries were found in the carotid artery (9.1%), the jugular vein (2.2%), and ruptures of the carotid adventitial layer (21.7%). These could be partially associated with the use of a hard fixed noose and body weight.

[1]  L. Kiss,et al.  Fatal suicide cases from 1991 to 2000 in Szeged, Hungary. , 2005, Forensic science international.

[2]  M. Angyal,et al.  A detailed study on suicides in Baranya County (Hungary) , 1995, International Journal of Legal Medicine.

[3]  O. Peschel,et al.  Characterization of haemorrhages at the origin of the sternocleidomastoid muscles in hanging , 2005, International Journal of Legal Medicine.

[4]  T. Rapson,et al.  Trends in suicide in Scotland 1981 – 1999: age, method and geography , 2004, BMC public health.

[5]  R. Byard,et al.  Changing patterns of female suicide: 1986-2000. , 2004, Journal of clinical forensic medicine.

[6]  Bernard Knight,et al.  Knight's Forensic Pathology , 2004 .

[7]  Bernard Knight,et al.  Knight's Forensic Pathology, 3Ed , 2004 .

[8]  P. Saukko,et al.  Fatal Pressure on the Neck , 2004 .

[9]  F. Gutzwiller,et al.  Are seasonalities in suicide dependent on suicide methods? A reappraisal. , 2003, Social science & medicine.

[10]  S. Nikolić,et al.  Analysis of Neck Injuries in Hanging , 2003, The American journal of forensic medicine and pathology.

[11]  J. Tiihonen,et al.  Seasonal variation in specific methods of suicide: a national register study of 20,234 Finnish people. , 2002, Journal of affective disorders.

[12]  B. Madea,et al.  Suicide in children, adolescents and young adults. , 2002, Forensic science international.

[13]  B. Agarwal,et al.  Accidental Hanging with Delayed Death in a Lift , 1999, Medicine, science, and the law.

[14]  X. H. Vidal,et al.  DISTRIBUCIÓN GEOGRÁFICA Y TENDENCIA DE LA MORTALIDAD POR SUICIDIO EN GALICIA 1976-1996. , 1999 .

[15]  M. A. Elfawal.  Cultural influence on the incidence and choice of method of suicide in Saudi Arabia. , 1999, The American journal of forensic medicine and pathology.

[16]  G. Feigin,et al.  Frequency of neck organ fractures in hanging. , 1999, The American journal of forensic medicine and pathology.

[17]  B. Brinkmann.  Harmonization of medico-legal autopsy rules. Committee of Ministers. Council of Europe. , 1999, International journal of legal medicine.

[18]  B. Brinkmann,et al.  Harmonisation of Medico-Legal Autopsy Rules , 1999, International Journal of Legal Medicine.

[19]  B. Ludes,et al.  Suicidal hanging resulting in complete decapitation: a case report , 1998, International Journal of Legal Medicine.

[20]  V. D. Khokhlov.  Injuries to the hyoid bone and laryngeal cartilages: effectiveness of different methods of medico-legal investigation. , 1997, Forensic science international.

[21]  A. Vesterby,et al.  Homicidal hanging masquerading as suicide. , 1997, Forensic science international.

[22]  W. Eisenmenger,et al.  Frequency of throat-skeleton fractures in hanging. , 1996, The American journal of forensic medicine and pathology.

[23]  H. Hougen,et al.  Suicides in two Scandinavian capitals--a comparative study. , 1996, Forensic science international.

[24]  B. Knight,et al.  Case report. Delayed death after pressure on the neck: possible causal mechanisms and implications for mode of death in manual strangulation discussed. , 1996, Forensic science international.

[25]  I. Morild.  Fractures of Neck Structures in Suicidal Hanging , 1996, Medicine, science, and the law.

[26]  D. Lester,et al.  Suicide and Homicide in Costa Rica , 1995, Medicine, science, and the law.

[27]  M. A. Elfawal,et al.  Deaths from Hanging in the Eastern Province of Saudi Arabia , 1994, Medicine, science, and the law.

[28]  J. Feczko,et al.  Asphyxial deaths due to hanging in children. , 1993, Journal of forensic sciences.

[29]  P. Silcocks,et al.  Suicidal hanging in Cardiff--a 15-year retrospective study. , 1992, Forensic science international.

[30]  K. Peng,et al.  Suicide and Parasuicide in Singapore (1986) , 1990, Medicine, science, and the law.

[31]  Dominick DiMaio,et al.  Forensic pathology. , 1990, BMJ.

[32]  J. Simonsen.  Patho-anatomic findings in neck structures in asphyxiation due to hanging: a survey of 80 cases. , 1988, Forensic science international.

[33]  J. Guarner,et al.  Suicide by Hanging: A Review of 56 Cases , 1987, The American journal of forensic medicine and pathology.

[34]  T. K. Marshall,et al.  Hanging in Northern Ireland—A Survey , 1986, Medicine, science, and the law.

[35]  J. L. Luke,et al.  Correlation of circumstances with pathological findings in asphyxial deaths by hanging: a prospective study of 61 cases from Seattle, WA. , 1985, Journal of forensic sciences.

[36]  G. Paparo,et al.  Neck markings and fractures in suicidal hangings. , 1984, Forensic science international.

[37]  D. Bowen.  Hanging--a review. , 1982, Forensic science international.