Injury of the vertebral artery in suicidal hanging

Saternus, K.‐S.

doi:10.1016/0379-0738(84)90076-8

Cited by 16 publications

(4 citation statements)

References 12 publications

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“…The fracture mechanism described by Jefferson (1920) is extension of the neck causing fracture of the atlas due to its compression between the occipital bone and the neural arch of the axis (Plaut, 1938;Hatchette, 1941;Sherk and Nicholas, 1970;Shapiro et al, 1973;Sherk, 1975). However, Jefferson fractures have also been shown to arise from various other injury mechanisms, i.e., during hyperflexion of the neck (Saturnus, 1984). Both the anterior and posterior arches of the atlas were fractured in Kelly's case and Skold (1983) reported that this arises as a result of tilting, oblique extension or flexion and traction of the neck.…”

Section: Discussionmentioning

confidence: 99%

“…Laceration and haemorrhage of the carotid artery has been associated with sudden and long drops such as that in judicial hangings (Spitz, 1993;Subramanyam, 1999). It is even more likely, however, that damage to the vertebral arteries occurred as this is much more prevalent than damage to the carotids (Saturnus, 1984). This may be attributed to the fact that the common carotid branches off from the external carotid and is not rigid at the fork.…”

Section: Discussionmentioning

confidence: 99%

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Cause of death in judicial hanging: a review and case study

Hellier

Connolly

2009

Med Sci Law

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The cause of death in judicial hanging is controversial and often attributed to 'hangman's fracture' of the second cervical vertebra. Research has shown that such fractures are the exception in judicial hangings and the cause of death can be attributed to a range of head and neck injuries, particularly compression or rupture of the vertebral and carotid arteries leading to cerebral ischaemia. The rapidity of loss of consciousness and death is highly dependent upon knot positioning and the length of drop which has varied through the history of hanging as a capital punishment in the UK. The skeletal remains of Mr. George Kelly, wrongfully hanged for murder at Walton prison, Liverpool (1950) were exhumed, examined and are reported on herein. The first cervical vertebra was found to be fractured but no 'hangman's fracture' of the axis--second cervical vertebra--was present. The hangman (Mr. Albert Pierrepoint) has been quoted as stating that the hanging of Mr Kelly took longer than 'it should have' (Dernley and Newman, 1989) but no skeletal evidence of death by strangulation was found by the authors. Unconsciousness, if not death, would probably have been rapid due to vertebral artery damage as a result of the observed neck fracture, although this cannot be concluded with absolute certainty.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cause of death in judicial hanging: a review and case study

Hellier

Connolly

2009

Med Sci Law

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“…This report corresponds to the theory that injuries of the blood vessels in hanging are caused by traction and not by direct pressure on a blood vessel. Saternus (1984) reported that intimal rupture of the vertebral artery (25% cases) was more common than that of the carotid artery on mechanical terms. The common carotid artery runs freely in the vessel space and its upper fixation at the level of the fork, due to the branching off of the external carotid, is not rigid.…”

Section: Discussionmentioning

confidence: 99%

Neck Structure Injuries in Hanging – Comparing Retrospective and Prospective Studies

2005

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Deaths due to hanging are common among suicides. Various studies in the forensic literature have reported considerable differences in the frequency of hyoid bone or thyroid cartilage fractures and injuries to the musculature and the vasculature of the neck. Some important reasons to which these variations could be attributed include: lack of a common method for examination of neck structures, varying degrees of thoroughness in examining the neck structures and lack of seriousness in the documentation of the findings (as cases of hanging are almost always suicidal) thus affecting the results of retrospective studies. The present study was conducted retrospectively (1994 to 1999) and prospectively (2000 to 2003) on 108 cases of hanging. Seventy-one per cent of the cases were male and 29% female, aged between 15 to 60 years. Hanging was typical in 20% of cases and atypical in 80%; it was complete hanging in 46% of cases and incomplete in 54% of cases. Neck structure fractures were found to be more common in atypical complete hangings; the incidence was found to be 10% in the retrospective group and 27% in the prospective group. Contusions and lacerations of musculature were found in 20% of cases in the retrospective group and 34% in the prospective group, thus stressing the need for thorough postmortem examinations and meticulous documentation of the findings.

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“…Large subintimal hematomas (10) or intramural bleeding can also result in the narrowing of the arterial lumen. Injuries of a similar nature occur also in the area of the vertebral arteries, and with an even higher frequency than in carotid arteries (11), especially in judicial hanging (12). Nevertheless, the carotid and vertebral arteries are not strictly comparable in mechanical terms.…”

mentioning

confidence: 99%

Amussat’s Sign in Hanging-A Prospective Autopsy Study

Hejna¹

2010

Journal of Forensic Sciences

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Amussat's sign is typically a transverse laceration of the intimal layer of carotid arteries described in cases of hanging. Subtotal laceration of the carotid artery is not strictly specific for hanging and can be also caused by blunt neck trauma, extreme overstretching, or whiplash-injuries. In a prospective autopsy study of 178 cases of hanging, Amussat's sign was found in 29 cases (a relative frequency of 16.1%). A statistically significant association between the occurrence of tears in the intimal layer of carotid arteries and the victims' age was discovered in the cases studied (the frequency increased with age; p<0.05). The occurrence of Amussat's sign was independent of gender, weight, completeness of the victim's body suspension, and position of the ligature knot on the neck. The study demonstrates the fact that the most probable cause of Amussat's sign is a combination of direct compression of the artery by the rope and indirect stretching because of the gravitational drag produced by the weight of the body.

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Injury of the vertebral artery in suicidal hanging

Cited by 16 publications

References 12 publications

Cause of death in judicial hanging: a review and case study

Cause of death in judicial hanging: a review and case study

Neck Structure Injuries in Hanging – Comparing Retrospective and Prospective Studies

Amussat’s Sign in Hanging-A Prospective Autopsy Study

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