Pattern of Injuries to Neck Structures in Hanging—An Autopsy Study

Abstract

One hundred eighty-nine cases of known dead bodies brought for medicolegal autopsy with alleged history of hanging were studied at the Department of Forensic Medicine, State Medico Legal Institute, Government Medical College, Thiruvananthapuram, Kerala, India. All the findings noticed during detailed external examination and flap dissection of the neck were analyzed with special emphasis on correlation between the external and internal injuries on neck.There was a preponderance of males in the study group (70.9%), majority of them being middle-aged (64.9%). Among females, the major group was composed of adolescents and young adults (72.8%). Easily available materials were used as ligature materials. Soft materials such as saree, shawl, lungie, and so on were used as ligature by 47% of victims and hard materials such as coir rope, plastic rope, telephone cable, and so on were used by 29% of victims. Oblique ligature mark was noted in 94.2% of cases. The ligature mark was noncontinuous in 78% of cases. Horizontal ligature marks were noted in cases of partial hanging.Rupture of muscle fibers at the lower attachment of sternomastoid was seen in 19.6%, and carotid intimal tear was seen in 1.1% of cases. Fracture of hyoid bone at their greater horns was seen in 2.7% and thyroid cartilage in 5.3% of cases. Vertebral fracture and dislocation were noted between third and fourth cervical vertebrae in 1.6% of cases. Neck skeleton injuries were noted in persons older than 38 years.

Suicidal Hanging in Eskisehir, Turkey: 25 Year Analysis

“…The hangings in the form that the body does not touch anywhere are called full hanging [1,13,41]. In the literature related to hanging, it is reported that full hanging is most frequently encountered [23,25,30,42]. In the study conducted in Samsun, it was reported that 77.1% of the cases were full hangings [42].…”

“…Vertebral fractures may occur in primordial executions and at very high distances [1,2,25]. Vertebral fractures may occur in the executions of death penalty and in hangings exercised at very high distances [1,2,25]. Also, in the 2 cases with vertebral fractures mentioned above, the hanging distance were high and both were oldaged.…”

“…In a study conducted in India, it was reported that there were vertebral fractures in 1.6% of the hanging cases [25]. Vertebral fractures may occur in primordial executions and at very high distances [1,2,25]. Vertebral fractures may occur in the executions of death penalty and in hangings exercised at very high distances [1,2,25].…”

“…One of these 2 cases was a 75 years old-woman hung herself on the roof of a 15-meter-high depot, while the other was a 67-year-old man hang himself from the roof to the elevator shaft in his workplace. In a study conducted in India, it was reported that there were vertebral fractures in 1.6% of the hanging cases [25]. Vertebral fractures may occur in primordial executions and at very high distances [1,2,25].…”

“…Neck region should be examined in detail during autopsy. Hemorrhage and ecchymoses in soft tissues under neck skin, ecchymotic fractures in hyoid bone and troit cartilage support that hanging has been performed while the person is alive [2,3,16,17,[22][23][24][25][26]. Whether the person was affected by a substance or alcohol at a level that could make him/her ineffective before death should be investigated by performing toxicological examination [2,[27][28][29].…”