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Background. There is a paucity of research on homicidal strangulation by gender. Objectives. A sex-disaggregated and comparative research approach was used to investigate individual-level risk factors for female and male homicidal strangulation in Johannesburg, South Africa (2001 - 2010). Methods. Data were drawn from the National Injury Mortality Surveillance System. Logistic regressions were used to examine associations between each of the independent variables and homicidal strangulation in females and males relative to all other female and male homicides, respectively. Results. The risk of fatal strangulation was high for both females and males aged ≥60 years, but markedly high only for male children and adolescents. Temporal risk for females was undifferentiated for day of the week, and the risk for males was high during weekdays. Females were more likely to be strangled in public places, and males in private locations. Conclusions. The study underlines the importance of disaggregating homicide by external cause and gender.

Death due to constriction of neck by ligature material may result due to hanging or strangulation. It can be homicidal, suicidal or in few cases it can be accidental. In some cases even police officials get confused about the case, whether it is homicidal or suicidal. And they interpret the case wrongly and at that point of time the role of forensic expert becomes important. A meticulous postmortem examination of the body and proper diagnosis can help police officials to direct the investigation towards the right path. One such case is being discussed here wherein the cause of death was guessed by police officials as suicidal hanging, but thorough postmortem examination revealed it to be a case of homicidal strangulation. This helped the police to register a case U/S 302 IPC and apprehend the accused.

Pulmonary oedema is a common problem seen at emergency treatment unit. Although cardiac causes of pulmonary oedema are so common, noncardiogenic causes are not rare. Sepsis with acute respiratory distress syndrome, fluid overload, expansion pulmonary oedema, hypoalbuminemia and neurogenic are the causes of pulmonary oedema. Here we present a rare homicidal case of pulmonary oedema. We considered presenting this case as many of us may not think or look for it unless we are aware of it.

A 24-year-old woman was strangulated by her husband using his wife's own 60-cm long artificial head hair integrations. During a domestic conflict, she was strangulated while lying in bed in a prone position. Her husband wrapped her hair around her neck and pulled it with one hand while fixing her head with the other hand. Due to the soft and broad nature of the ligature, the neck skin presented scarcely any ligature marks and showed a horizontal pale area in the middle of the neck above which the neck and face were congested; the skin showed extensive petechial haemorrhages. The autopsy revealed no internal injuries except two small haematomas in the soft tissue on each side of the neck. These were located under the pale area of the skin. The larynx and hyoid bone were intact. No natural disease was found. The toxicological analyses showed negative results. This is the first report of a homicidal strangulation by means of the victim's own artificial hair extensions.

A severely burned body was found lying on its right side at the scene of the fire in a 2-story wooden apartment house. The presence of a ligature (an electrical cord) running horizontally around the neck aroused suspicion of arson after homicidal strangulation (murder-arson). The entire body was severely burned and partly charred. The head and neck were severely charred, and the left temporal bone had been consumed exposing the brain. Around the neck was looped an electrical cord, which ran horizontally and canted downward toward the nape, leaving a furrow resulting from the knot being tightened up. No other injuries or pathologic lesions suggestive of the cause of death were noted. No drug, poison or alcohol was detectable in the blood or urine. The peculiar method of making a noose of the ligature around the neck is called clove hitch, which makes the noose tighten further with increased load. The fallen curtain rod had a bend with an acute angle, which was considered to have been the point of suspension in hanging. In addition, a lighter was found under the corpse, which was presumably used to ignite the gasoline that the deceased sprinkled. We speculate, therefore, that the deceased hanged himself by placing the electrical cord around his neck (by clove hitch), suspending it from the curtain rod, sprinkling gasoline in his room, igniting it with a lighter, executing suicidal hanging after the start of the fire. Probably the body was wrapped in flames while dangling, then fell to the floor together with the collapsing curtain rod.

We report an unusual case of homicidal strangulation of a healthy woman using her own head hair as the ligature. An attempt was made by the accused murderer to mask the homicide. Autopsy findings are presented that emphasize the lack of injuries to the deep neck structures when a soft, broad ligature is used. This case also highlights the difficulties arising in interpretation of pathological findings in asphyxial deaths, when the circumstances are not available and the ligature is not in place. Review of the English language literature found no similar case.

Some cases of suspected homicidal strangulation are difficult to diagnose if the classical injuries of strangulation are few or lacking. The main purpose of this study was to determine if abnormal distension of alveolar airspaces is present in strangulation deaths and whether or not it can be used to support this diagnosis. Another purpose was to see how often the gross examination of the lungs was in agreement with the microscopic examination. The material comprised 33 victims of homicidal strangulation above the age of 15 years, autopsied at the Department of Forensic Medicine in Copenhagen between 1998 and 2007. The results were compared with a control group of the same size, matched for gender and age, all of whom died naturally of cerebral or other neurological causes. The autopsy reports provided the results of the gross examination of the lungs. Regular haematoxylin–eosin stained sections were made from the histological specimens. The microscopic examination was performed by computerized image analysis using stereological methods in an attempt to objectify the observations. The results showed an almost complete concordance between the findings of the gross and the microscopic examination. Stereologically the study showed that the alveoli in the strangulation cases were twice the size of those in the control group which was highly statistically significant concluding that abnormal distension of alveolar airspaces.

The objective of the present study was to estimate the proportion of hanging victims presenting with limb lesions, to compare this rate between hanging in restraint spaces and in more open settings, and to describe the usual pattern of limb lesions associated with hanging. Two hundred and seven cases of suicidal hanging were retrospectively reviewed and compared to 45 homicidal nonhanging strangulation victims. Bruises incidence was significantly lower in hanging victims (19.8%) compared to homicidal strangulation victims (55.6%). Bruises were more commonly encountered in restraint areas such as closets and staircases (56.3% and 66.7%, respectively) than in more open settings such as barn, bridge, fence, and park. Limb bruises on hanging victims were generally located on the posterior upper limb or the anterior lower limbs, whereas strangulation victims did not display this preferential bruises concentration. Possible suspicion criteria for limb bruises distribution are discussed, in relation to physiopathology of human asphyxia by hanging.

Self-strangulation by ligature is distinctly uncommon. It is distinct from self-suspension in cases of hanging, the latter being a far more common form of suicide. Self-strangulation must be separated from homicidal strangulation and from accidental sexual asphyxia. The ligature in suicidal strangulation may be knotted or tightened like a tourniquet. As the ligature is tightened the face and neck may become congested due to slow venous compression. Laryngeal fractures are rare and injuries are mild and often confined to the single ligature mark around the neck. The three cases discussed here were initially treated by the police as suspicious. Detailed examination of the scene and of the deceased person, along with investigation of the circumstances leading to the death, produced clear verdicts of suicide in all three cases.

This chapter is based on a number of research projects on offender profiling and homicidal crime scene behavior carried out at the Finnish National Bureau of Investigation. This specific study investigated homicidalstrangulation in Finland during a 7-year period and analyzed and compared offense and offender characteristics in manual and ligature strangulation cases. The results diverge in many respects from the previous research findings attributed to homicidal strangulation and emphasize the need to identify possible culture-specific patterns and psychopathological offender characteristics in homicidal behavior.

Hemorrhages of the tongue can be useful for the diagnosis in cases of lethal neck compression. The reported frequencies of tongue bleedings in the literature in cases of suicidal hanging range from 0 to 14% and in homicidal strangulation (str.) from 5 to 37%. This study gives a summary of the incidence and intensity of tongue bleedings in cases of homicidal str. by ligature, manual str., suicidal str. by ligature and suicidal hanging. In 25% of all homicides significant or massive hemorrhages of the tongue were detected. In contrast to this, in suicidal hanging the tongue was unaffected in 95%. The causes of massive hemorrhages here (2%) could be explained by an “abnormal” position of the loop.

73 pISSN 1225-0589 eISSN 2287-2078 cCopyright 2014 by the Korean Society for Legal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Korean J Leg Med 2014;38:73-77 http://dx.doi.org/10.7580/kjlm.2014.38.2.73

Compression of the neck, either with the hands or by a ligature, is not an uncommon method of homicide. Burning of the body to try to conceal the homicide may complicate the situation by making it difficult to interpret the findings. We hereby report two cases of homicidal ligature strangulation with extensive burning of the bodies. In both cases, external findings included the presence of a soft piece of fabric around the neck that, when removed, disclosed a portion of pale, unburned skin that vividly contrasted with surrounding areas. Osteocartilaginous lesions were present in only one case. Carboxyhemoglobin levels in both cases were very low, and the histopathologic examination of distal airways for soot particles was negative. Language: en

The hyoid is the U-shaped bone of the neck that is fractured in one-third of all homicides by strangulation. On this basis, postmortem detection of hyoid fracture is relevant to the diagnosis of strangulation. However, since many cases lack a hyoid fracture, the absence of this finding does not exclude strangulation as a cause of death. The reasons why some hyoids fracture and others do not may relate to the nature and magnitude of force applied to the neck, age of the victim, nature of the instrument (ligature or hands) used to strangle, and intrinsic anatomic features of the hyoid bone. We compared the case profiles and xeroradiographic appearance of the hyoids of 20 victims of homicidal strangulation with and without hyoid fracture (n = 10, each). The fractured hyoids occurred in older victims of strangulation (39 +/- 14 years) when compared to the victims with unfractured hyoids (30 +/- 10 years). The age-dependency of hyoid fracture correlated with the degree of ossification or fusion of the hyoid synchondroses. The hyoid was fused in older victims of strangulation (41 +/- 12 years) whereas the unfused hyoids were found in the younger victims (28 +/- 10 years). In addition, the hyoid bone was ossified or fused in 70% of all fractured hyoids, but, only 30% of the unfractured hyoids were fused. The shape of the hyoid bone was also found to differentiate fractured and unfractured hyoids. Fractured hyoids were longer in the anterior-posterior plane and were more steeply sloping when compared with unfractured hyoids. These data indicate that hyoids of strangulation victims, with and without fracture, are distinguished by various indices of shape and rigidity. On this basis, it may be possible to explain why some victims of strangulation do not have fractured hyoid bones.

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The morbid anatomical findings in 84 cases of strangulation are presented. The incidence of homicidal strangulation is given by age, sex and method employed. The patterns of injury are reviewed; injuries to the cartilages, and to the carotid arteries, are found to occur more frequently than a review of the literature would suggest. The effects of age and type of ligature on the findings are examined. The experience of other observers that hyoid and laryngeal injury is increasingly common in older subjects is confirmed. It is tentatively suggested that carotid artery injury is related to degenerative vascular disease. The extent of injury in ligature strangulation is related to the width and elasticity of the ligature and to the force applied, and may resemble that seen in manual strangulation if a broad ligature has been used.

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