Significance of Hemorrhages at the Origin of the Sternocleidomastoid Muscles in Hanging

Hejna, Petr; Zátopková, Lenka

doi:10.1097/paf.0b013e31820b8fb8

Cited by 25 publications

(11 citation statements)

References 14 publications

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“…Many authors have determined the fact that the victim was still alive prior to the active hanging by multiple hemorrhages in soft tissues adjacent to the decapitation line in the neck area (4,5) as well as by hemorrhages at the clavicular (or sternal) origin of the sternocleidomastoid muscles (48,49). Hemorrhages at the clavicular origin of the sternocleidomastoid muscles were detected in all our cases and thus can be considered as a helpful diagnostic finding in similar cases (49).…”

Section: Discussionmentioning

confidence: 53%

Decapitation in Suicidal Hanging – Vital Reaction Patterns

Hejna

Bohnert

2012

Journal of Forensic Sciences

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Complete or incomplete decapitation as a consequence of suicidal hanging is very rare, few cases having been reported in the worldwide literature. Posthanging decapitation is typically related to a drop of several meters. Three cases of complete decapitation and one case of incomplete decapitation by suicidal hanging are reported with particular emphasis on internal findings and vital reaction patterns. Personal, circumstantial, autopsy, and toxicological data were analyzed to define basic characteristics of such extreme injuries. The crucial factor for the state of decapitation itself is the kinetic energy of the falling body, the strength of the human neck tissue, and the diameter and elasticity of the used ligature. Results of our case study suggest Simon's hemorrhage and air embolism as useful autopsy findings in posthanging beheading cases. Simon's hemorrhage was demonstrated in three cases of four. The test for air embolism was positive in all four cases.

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Section: Discussionmentioning

confidence: 53%

Decapitation in Suicidal Hanging – Vital Reaction Patterns

Hejna

Bohnert

2012

Journal of Forensic Sciences

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“…3,7 They generally consist in muscular hemorrhages at their attachment to the sternum. 2 The frequency of this finding would be significantly higher on the side of the highest point of the ligature mark, thereby supporting the hypothesis of extension as the causative mechanism. 3 This observation was confirmed by Hejna et al, 2 who found a significant association between the occurrence of hemorrhages and the location of the ligature knot on the neck.…”

Section: Discussionmentioning

confidence: 64%

“…Hemorrhage at the origin of the sternocleidomastoid muscles is a frequent finding. 2,3 Conversely, rupture of these muscles is an uncommon injury found at autopsy. 4 Rupture of carotid artery is also a rare finding, except in case of hanging complicated with decapitation.…”

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confidence: 94%

Traumatic Rupture of Deep Neck Structures in Hanging

Advenier

Grandmaison

2014

American Journal of Forensic Medicine &Amp; Pathology

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Injuries to the neck structures are various in case of hanging. Soft tissue lesions generally consist in sternocleidomastoid and subhyoid muscle hemorrhages. Traumatic ruptures of deep neck structures are rare. We report 2 cases of partial and complete ruptures of sternocleidomastoid muscles after suicidal hanging. Both were typical and complete hanging. In 1 case, muscle laceration was associated with common carotid rupture on the same side. Hemorrhage at the rupture site was only found at the microscopic level. Such injuries may result from the ligature's compression and depend on duration of suspension. Heavy body weight, rigid rope material, and fall after a jump may promote their occurrence.

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“…The presence of vital signs is commonly characterized in the forensic literature as local macro-and micro-morphological findings in hanging, which serve as additional criteria for the reconstruction of the sequence of events [4]. As systemic reactions, pulmonary atelectasis, pulmonary microembolism syndrome, and hemorrhages of the bowel and of the accessory breathing muscles have been described in addition to local lesions such as ''Simon's bleedings'' [5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Remarkable findings in suicidal hanging

Tattoli

Buschmann

Tsokos

2014

Forensic Sci Med Pathol

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A 71-year-old man was found dead in his apartment hanging by a tie that was fixed to the upper hinge of a door. His feet were touching the ground. It was known that he had tried to commit suicide before. At medico-legal autopsy a single furrow was found on the neck with a ligature knot behind the left mandibular angle. Dissection of the neck's soft tissue in layers revealed bilateral fresh hemorrhages in the pharyngeal tonsils with macroscopic delineation of gland follicles (Fig. 1). Fractures of both superior horns of the thyroid cartilage, superficial hemorrhage in the tongue's base, and petechiae of the facial skin and conjunctivae were also present. Except for brain swelling, pulmonary edema, and severe generalized atherosclerosis, no other findings were observed. Toxicological investigations were negative. The cause of death was declared as hanging and the manner of death was ruled suicide. Case 2A 74-year-old man was found hanging from the railing of a bridge, freely suspended by a hemp rope with an estimated drop of 3.5-4 m. The deceased was 160 cm tall and weighed 77 kg. The 1 cm thick rope compressed the neck with a knot on the anterior area of the neck forming a loop that ran above the laryngeal protuberance. The loop ended in a fixed ligature knot behind the left ear. At external examination, dried saliva was found coming out of the right corner of the mouth, draining down over the chin. Autopsy revealed bilateral symmetrical hemorrhages at the sternal insertion of the periosteal-clavicular origin of the sternocleidomastoid muscles, and a complete laceration of all tissue layers between the cricoid cartilage and the hyoid bone that crossed the upper part of the thyroid cartilage and exposed the laryngeal mucosa. The trachea contained a small amount of fine froth with no signs of blood aspiration. A full-thickness transverse laceration, as well as superficial tears in the intima of the right common carotid artery, were also seen proximal to the bifurcation (Fig. 2). Hemorrhages (''Simon's bleedings'') beneath the anterior longitudinal ligament of the thoracic and lumbar spine were also present. Toxicological analysis was unremarkable. Case 3A 34-year-old man was found hanging in free suspension by a rope in his apartment. According to the man's medical history he had suffered from a depressive disorder. A suicide note was found in the flat. At external examination, a strangulation mark was visible with signs of suspension below the left ear. At autopsy, the most remarkable finding was hemorrhage beneath the anterior longitudinal ligament L. Tattoli

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Significance of Hemorrhages at the Origin of the Sternocleidomastoid Muscles in Hanging

Cited by 25 publications

References 14 publications

Decapitation in Suicidal Hanging – Vital Reaction Patterns

Decapitation in Suicidal Hanging – Vital Reaction Patterns

Traumatic Rupture of Deep Neck Structures in Hanging

Remarkable findings in suicidal hanging

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