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Copyright of Die Radiologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Post mortem hyoid bone fracture findings may be attributable to various factors, including both the onset of acute mechanical asphyxia as it happens in manual strangulation and in charred corpses. In forensic practice, the discovery of corpses burned after death to hide their real cause of death is not uncommon: in these cases, the diagnostic challenge is even greater, as the action of flames is capable of both masking previously generated lesions and/or generating new ones, as occurs for hyoid bone fractures. The case concerns a 76-year-old man found charred in his bedroom. Almost complete body charring made it impossible to evaluate any external damage. Post mortem computed tomography (PMCT) was performed, and an evident bilateral fracture of the greater horn of the hyoid bone was detected. Although the absence of typical charring signs had steered the diagnosis towards post mortem exposure to flames, PMCT proved to be very useful in increasing the accuracy in correctly determining the cause of death. In particular, making use of Maximum Intensity Projection (MIP) hyoid bone reconstructions, it was possible to measure the medial dislocation angle of the fracture fragments and then to establish the applied direction of force, which acted in a lateral–medial way. A manual strangulation diagnosis was confirmed. The increasing importance of performing post mortem radiological exams as a corollary for conventional autopsy has been further confirmed. [ABSTRACT FROM AUTHOR]

Post mortem hyoid bone fracture findings may be attributable to various factors, including both the onset of acute mechanical asphyxia as it happens in manual strangulation and in charred corpses. In forensic practice, the discovery of corpses burned after death to hide their real cause of death is not uncommon: in these cases, the diagnostic challenge is even greater, as the action of flames is capable of both masking previously generated lesions and/or generating new ones, as occurs for hyoid bone fractures. The case concerns a 76-year-old man found charred in his bedroom. Almost complete body charring made it impossible to evaluate any external damage. Post mortem computed tomography (PMCT) was performed, and an evident bilateral fracture of the greater horn of the hyoid bone was detected. Although the absence of typical charring signs had steered the diagnosis towards post mortem exposure to flames, PMCT proved to be very useful in increasing the accuracy in correctly determining the cause of death. In particular, making use of Maximum Intensity Projection (MIP) hyoid bone reconstructions, it was possible to measure the medial dislocation angle of the fracture fragments and then to establish the applied direction of force, which acted in a lateral–medial way. A manual strangulation diagnosis was confirmed. The increasing importance of performing post mortem radiological exams as a corollary for conventional autopsy has been further confirmed.

Background: Fatal neck pressure may arise from hanging, ligature strangulation and manual strangulation. The analysis aimed to evaluate the demographic profiles of deadly neck pressure concerning ligature material, its position on the neck and the pattern of neck injuries with the manner of death in autopsied cases at Universiti Kebangsaan Malaysia Medical Center (UKMMC). Materials and Methods: A 20-year retrospective analysis was conducted at UKMMC, where 287 cases were sampled; out of which 267 cases were suicidal hanging, and four were accidental hanging. Only 11 cases of ligature strangulation and five cases were due to manual strangulation. The details were obtained from the autopsy report and IBM SPSS Statistics 28 analysis. Results: This study showed that 210 (73.2%) males and 77 (26. 8%) females with a ratio of 2.7:1 had died of fatal neck pressure. Male dominance (74.5%) was displayed in suicidal hanging, and there was no sex difference in ligature and/or manual strangulation. Ligature and manual strangulation were common in the younger age group. Accidental strangulation in young adults was most probably due to auto-erotic asphyxia. In this study, the youngest was 1 year, while the oldest was 85 years. The most common ligature used in suicidal hanging and homicidal ligature strangulation was hard material. The most typical pattern of the neck finding was facial congestion (71.1%), followed by petechial haemorrhages, neck muscle contusion, hyoid bone fracture, thyroid cartilage fracture and carotid injury (1.7%). Conclusion: Forensic pathologists' experience and autopsy techniques are fundamental in explaining the injury pattern and its correlation with fatality. [ABSTRACT FROM AUTHOR]

Background: Fatal neck pressure may arise from hanging, ligature strangulation and manual strangulation. The analysis aimed to evaluate the demographic profiles of deadly neck pressure concerning ligature material, its position on the neck and the pattern of neck injuries with the manner of death in autopsied cases at Universiti Kebangsaan Malaysia Medical Center (UKMMC). Materials and Methods: A 20-year retrospective analysis was conducted at UKMMC, where 287 cases were sampled; out of which 267 cases were suicidal hanging, and four were accidental hanging. Only 11 cases of ligature strangulation and five cases were due to manual strangulation. The details were obtained from the autopsy report and IBM SPSS Statistics 28 analysis. Results: This study showed that 210 (73.2%) males and 77 (26. 8%) females with a ratio of 2.7:1 had died of fatal neck pressure. Male dominance (74.5%) was displayed in suicidal hanging, and there was no sex difference in ligature and/or manual strangulation. Ligature and manual strangulation were common in the younger age group. Accidental strangulation in young adults was most probably due to auto-erotic asphyxia. In this study, the youngest was 1 year, while the oldest was 85 years. The most common ligature used in suicidal hanging and homicidal ligature strangulation was hard material. The most typical pattern of the neck finding was facial congestion (71.1%), followed by petechial haemorrhages, neck muscle contusion, hyoid bone fracture, thyroid cartilage fracture and carotid injury (1.7%). Conclusion: Forensic pathologists' experience and autopsy techniques are fundamental in explaining the injury pattern and its correlation with fatality.

Background: Mechanical asphyxia (MA) is multi-classified. Some epidemiological characteristics are shared and the others different among different MA types. Aims and Objectives: To reveal the characteristics of different types of MA and provide reference data for forensic identification of MA. Materials and Methods: We analyzed 913 cases to reveal the epidemiological characteristics of MA in Dongguan and Guangzhou, China. Results: Seven types of MA were identified and strangulation accounted for up to 89.2%. Those aged 20-29 were the most susceptible to all types, except for traumatic and positional asphyxia. Suicide accounted for 96.6% of hanging cases, and accident was the main manner of death in cases of choking, traumatic, and positional asphyxia. Homicide was the most common in cases of ligature strangulation (LS), manual strangulation (MS), smothering, and asphyxia concomitant with lethal mechanical injury. The homicide rate in LS was positively correlated with the rate of female victims (P

Recent research indicates that some young people initially learn about sexual choking through Internet memes. Thus, a qualitative content analysis was performed on 316 visual and textual memes collected from various social media websites and online searches to assess salient categories related to choking during sex. We identified nine main categories: communication, gendered dynamics, choking as dangerous, choking as sexy, sexualization of the nonsexual, shame and worry, romance/rough sex juxtaposition, choking and religious references, instructional/informational. Given that memes, through their humor, can make difficult topics more palatable and minimize potential harm in the phenomenon they depict, more concerted, synergistic effort that integrates media literacy into sexuality education programming on the potential risks that may ensue for those engaging in sexual choking is warranted. [ABSTRACT FROM AUTHOR]

Clinical Problem: Detection of manual strangulation, choking and hanging, as well as the intensity of these actions, helps to clarify the course of events, to enforce the state's right to prosecute and ultimately to protect against further attacks. However, this is complicated by the scarcity of externally visible findings., Standard Procedure to Date: The forensic examination of the head and neck after strangulation is carried out by means of external inspection to detect injuries and congestion above the strangulation level. Lesions below the surface of the skin, in particular of the subcutaneous fat tissue, the muscles or the laryngeal structures, usually escape the external inspection., Forensic Radiology as an Important Component: Imaging techniques allow internal injuries to be recorded and objectified, which can be of considerable added value in the collection of evidence. Since criminal proceedings must meet the highest standards of security, high demands are placed on imaging and diagnosis., Assessment: Imaging techniques are suitable for detecting and objectifying internal injuries after a person has survived strangulation. However, their excellent reconstruction and visualization capabilities also make them a valuable addition to postmortem examinations., Recommendations for Practice: After reported and survived strangulation, choking or hanging, magnetic resonance imaging (MRI) of the soft tissues of the neck should be performed as soon as possible, and if cerebral damage is suspected, the skull should also be examined. If the event was not survived, whole-body computed tomography (CT) is now standard practice at many forensic medicine institutes., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Although sexual choking is now prevalent, little is known about how people engage in choking in terms of frequency, intensity, method, or potential health sequelae. In a campus-representative survey of undergraduate and graduate students, we aimed to: (1) describe the prevalence of ever having choked/been choked as part of sex; (2) examine the characteristics of choking one's sexual partners (e.g., age at first experience, number of partners, frequency, intensity, method); (3) examine the characteristics of having been choked during sex; and (4) assess immediate responses of having been choked including the extent to which frequency and method (e.g., hand, ligature, limb) of having been choked predicts the range of responses endorsed by participants. A total of 4254 randomly sampled students (2668 undergraduate, 1576 graduate) completed a confidential online survey during Spring 2021. The mean age of first choking/being choked was about 19, with more undergraduates than graduate students reporting first choking/being choked in adolescence. Women and transgender/gender non-binary participants were significantly more likely to have been choked than men. Participants more often reported the use of hands compared to limbs or ligature. Common responses to being choked were pleasurable sensations/euphoria (81.7%), a head rush (43.8%), feeling like they could not breathe (43.0%), difficulty swallowing (38.9%), unable to speak (37.6%), and watery eyes (37.2%). About 15% had noticed neck bruising and 3% had lost consciousness from being choked. Greater frequency and intensity of being choked was associated with reports of more physical responses as was use of limb (arm, leg) or ligature. [ABSTRACT FROM AUTHOR]

Objective: Non‐fatal strangulation assessment is challenging for clinicians as clear guidelines for evaluation are limited. The prevalence of non‐fatal strangulation events, clinical findings, frequency of injury on computed tomography angiogram (CTA) and outcomes across two trauma centres will be used to improve this assessment process. Methods: This is a retrospective observational study of adult presentations during 2‐year period to two major‐trauma referral hospitals and subsequent 12 months to identify delayed vascular injury. Patients included using standardised search terms. Demographic data, clinical findings, radiological reports and outcomes were included for review. Results: A total of 425 patients were included for analysis. Self‐inflicted injury comprised 62.1%, with domestic violence (28.5%) and assault (9.4%) the remainder. Manual strangulation events 36.7% of overall presentations and 63.3% following ligature strangulation (ligature strangulation, incomplete and complete hanging). On examination soft signs present in 133 (31.2%) cases, commonly neck tenderness in isolation. No hard signs suggesting vascular damage. Vascular injury was demonstrated in three cases (0.7% of the total cohort and 1.5% of CTA scans completed), and all occurred in ligature strangulation events as a result of hanging. No patients had delayed vascular injury in the 12‐month period post‐initial presentation. Conclusions: In non‐fatal strangulation presentations, the majority have subtle signs of neck injury on examination with inconsistent documentation of findings. Low rate of vascular injury overall (0.7%), and entirely in hanging events. No longer‐term vascular sequalae identified. Improving documentation focusing on hypoxic insult and evidence of airway trauma is warranted, rather than a reliance on computed tomography imaging to delineate a traumatic event in non‐fatal strangulation. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to evaluate the effect of manual strangulation of the uterine isthmus on the amount of blood loss during cesarean section.Material and Methods: This is a prospective randomized controlled trial. A total of 118 participants were enrolled in the study. Manual strangulation of the uterine isthmus just after placental removal was performed during cesarean section in group I (n = 57; the strangulation group). Strangulation was not performed in group II (n = 61; the control group). Preoperative and postoperative venous blood hemoglobin, capillary hemoglobin, and absorbed blood levels during the operation were compared between the two groups.Results: The median age of the patients was 28.5 (19-41). The median body mass index of the patients in the study was 27 (21-42). There were no significant differences in the demographic characteristics of the patients between the groups. The median difference between the preoperative and postoperative 4-6 h capillary hemoglobin values was significantly lower in the strangulation group (2.0 (0-9)) than in the control group (3.0 (0-8)). The amount of absorbed blood during the operation was also significantly lower in the strangulation group (164.5 ml (69-1310)) than in the control group (230 ml (35-3223)).Conclusions: Manual uterine strangulation of the uterine isthmus immediately after the removal of the placenta may induce a 30% decrease in blood loss during cesarean section. [ABSTRACT FROM AUTHOR]

The pattern of neck injuries sustained in fatal cases of external compression to the neck is recorded during Post Mortem Examinations (PME), to assist in the interpretation of the circumstances that led to death. In this study, the PMEs performed for 298 cases of hanging and strangulation occurring between 2016 and 2020 in Ireland were retrospectively reviewed for the purpose of recording and collating the external and internal neck injuries observed during each PME, as well as the toxicology results for each decedent. Statistical analysis was performed to investigate potential novel associations between anthropometric variables pertaining to the decedents and the PME findings in cases of hanging and strangulation, serving to add further data to the existing body of research in this area and to assist in the resolution of future cases of hanging or strangulation where there are conflicting findings. In completing statistical analysis, it was found that there was no discernible association between the occurrences of cartilaginous neck fractures (CNFs) with increasing ligature width. Positive associations between increasing weight and BMI of the decedents were identified, and a significantly positive association between the increasing height of the decedent and the incidence of CNFs were identified. Analysis of the toxicology demonstrated that antipsychotics were implicated most frequently in cases of incomplete and complete hanging associated with CNFs and that opioids were implicated most frequently in cases of manual and ligature strangulation associated with CNFs. To record the pattern of neck injuries sustained in retrospective cases of hanging and manual/ligature strangulation and to collate these findings so as to provide scientific evidence to support the interpretation of the findings in future cases of suicidal hanging and homicidal manual/ligature strangulation for the purpose of medicolegal investigation. To analyse the associations between the occurrence of neck fractures and anthropometric variables pertaining to the victims in cases of complete hanging. The reports of 298 Post Mortem Examinations (PMEs) performed for cases of hanging and manual/homicidal ligature strangulation between 2016 and 2020 in Ireland were retrospectively reviewed. Pseudoanonymised data sets were recorded for each report, which included the following parameters: neck injuries (soft tissue and cartilaginous), weight, height, BMI and ligature width, toxicology, noose position, ligature material, tongue protrusion, sex and age. Permission for the use of this data was sought from the pathologists and coroners involved in these cases. The data was analysed according to descriptive statistical methods and logistic regression analysis. Logistic regression analysis was undertaken to examine the associations between unit increases in ligature width and increases in a set of physical characteristics of the decedents (weight, BMI and height) with the occurrence of CNFs. Increasing ligature width was not found to increase the likelihood of a CNF occurring, where the Odds Ratio (OR) for this event occurring was 0.9596. Unit increases in body weight and BMI were found to increase the likelihood of the occurrence of a CNF with ORs of 1.0166 and 1.0607 respectively. Increasing height of the decedent yielded an OR = 4.64, demonstrating that CNFs are significantly more likely to occur with increasing height (CI 95 %: 0.2915, 73.9559). According to the statistical analysis performed for this study, increasing weight, height and BMI are parameters of the decedents which increase the likelihood of the occurrence of CNFs in cases of complete hanging. • Hyoid, Laryngohyoid, Thyrohyoid cartilage. • Incomplete and complete hanging. • Manual Strangulation and Homicidal Ligature Strangulation. • Neck Compression, Neck Cartilage or Neck Fracture. [ABSTRACT FROM AUTHOR]

History of neck trauma should be promptly investigated in patients with severe infections of the chest as mediastinitis. We present a forensic case of a death due to a mediastinitis in a patient with an undetected fracture of the superior horn of the thyroid cartilage that was exclusively revealed at autopsy examination. Histological analyses of the neck tissues showed signs of pharyngeal mucosal microperforation caused by the fracture and surrounded by an inflammatory reaction. The fracture was caused by a not declared manual strangulation attempt, happened several days before medical evaluations. We share our experience to emphasize the importance of revealing the etiologies of fatal infections of the mediastinum both for clinical and forensic purposes. [ABSTRACT FROM AUTHOR]

In many countries, hanging is the most common suicide method. When a person is found hanged however, one always has to consider that the alleged suicide scene possibly covers up a homicide. In such cases, hanging may have been the actual method of killing or the victim may have been harmed by a different method and was subsequently hanged. Apart from the inspection of the scene, the autopsy findings are of great importance to differentiate between suicide and homicide. Up to now, a considerable number of cases have been observed in which suicide by hanging was wrongly assumed at first. In the case presented, there were some facts raising doubts about a suicidal act already at scene. Nevertheless the forensic pathologists erroneously assumed that the findings on the corpse were consistent with suicide. The later elucidation of the case as a homicide by manual strangulation with subsequent suspension of the victim was essentially based on a new assessment of the autopsy findings in a second opinion. [ABSTRACT FROM AUTHOR]

A case of death of a healthy male in his early forties is described, where three different asphyxial methods, i.e., manual strangulation, smothering and traumatic asphyxia by thoracic compression were used. The interest in the case is generated because all this three methods were carried out by a single assailant. Nail scratch abrasions were present on the cheek and neck. Internal examination revealed haemorrhagic infiltration into the muscles of the neck, contusion of the inner wall of upper respiratory tract and fracture of the hyoid bone. The autopsy findings helped the forensic pathologist in reconstructing the sequence of events and the manner in which the act was carried out. This case highlights the possibility of the involvement of a single person only, in the homicide of a healthy adult male by the application of three different asphyxial methods.

The aim of this case report was to demonstrate the importance of detailed clinical assessment in victims of attempted manual strangulation, to prevent the occurrence of delayed death due to an airway collapse; and to provide an update on clinical management of these patients. An elderly male patient presented with a sore throat and speech impairment after attempting manual strangulation. Physical examination showed reddish skin of the neck, an extensive haematoma of the hard palate and anterior tongue. Flexible laryngoscopy failed to show any swelling of the hypopharynx or larynx. A few hours after presentation, the patient developed acute dyspnoea and died. Autopsy and post-mortem CT scan showed a haematoma in the thyro-epiglottal space. In conclusion, victims of manual strangulation can survive despite internal neck injury which can lead to delayed fatal airway collapse. This is because often there are few or no signs of assault, therefore medical evaluation should be thorough and timely. Sometimes immediate tracheotomy can be life saving.

A case of death of a healthy male in his early forties is described, where three different asphyxial methods, i.e., manual strangulation, smothering and traumatic asphyxia by thoracic compression were used. The interest in the case is generated because all this three methods were carried out by a single assailant. Nail scratch abrasions were present on the cheek and neck. Internal examination revealed haemorrhagic infiltration into the muscles of the neck, contusion of the inner wall of upper respiratory tract and fracture of the hyoid bone. The autopsy findings helped the forensic pathologist in reconstructing the sequence of events and the manner in which the act was carried out. This case highlights the possibility of the involvement of a single person only, in the homicide of a healthy adult male by the application of three different asphyxial methods. [ABSTRACT FROM AUTHOR]

Introduction: Strangulation is a medicolegal form of mechanical asphyxia, and can be difficult to identify if cutaneous damage to the neck is limited. We began by creating a numerical model of a hyoid bone with adjustable anthropometric parameters and then subjected our model to compression simulating a precision grip on the neck from the front.Materials and Methods: We selected six bones from the 77 hyoid bones contained in the database we created during a previous study led by our laboratory, in which we demonstrated the sexual dimorphism of this bone and identified the minimal force required for fracture. The anthropometric characteristics of these six bones (angle, length and width) corresponded to those of the 10th, 50th and 90th percentiles from cluster 1 (male individuals) and cluster 2 (female individuals), respectively. After enhancing, developing and meshing the selected 3D models, we analysed and reproduced simulation conditions that were as close as possible to the in vivo conditions of neck strangulation from the front (area of pressure on the bone, tissue environment, and biological variability of this bone).Results: We modelled the six numerical hyoid bone models using the finite element method. For all models, the simulation of mechanical pressure applied to simulate anterior strangulation resulted in fractures. The forces required to produce these fractures matched the results obtained in the experimental testing of dissected hyoid bones.Conclusion: Six finite element numerical models were created, covering the anthropometric morphological variability of the hyoid bone. These six models enabled numerical simulation of the in vivo behaviour of a hyoid bone subjected to one-handed strangulation. [ABSTRACT FROM AUTHOR]

When a body is found in suspended position, not only suicidal hanging has to be considered but also an accident or homicide. These alternatives and the criteria to be applied for their differentiation were already extensively discussed in the old medico-legal literature. Nevertheless, it is still a challenge for detectives and forensic experts to prove a homicidal assault when a suspended body is found. In the presented case, the findings collected at the scene and during autopsy seemed to be consistent with the assumption of suicide at first and the case has only been elucidated by supplementary inquiries and a secondary evaluation of the photos taken at the scene and during the autopsy. The victim, a 47-year-old woman, had been manually strangled in her flat. Subsequently, the perpetrator took her up to the attic and tried to hang her in order to simulate suicide. [ABSTRACT FROM AUTHOR]

Postmortem computed tomography (CT) is now routinely performed in forensic autopsies. Microfocus computed tomography (mfCT) has attracted recent attention because it can provide more detailed information than routine postmortem CT can. This feasibility study evaluated the usefulness of mfCT for examination of the hyoid bone and thyroid cartilage in cases of suspected strangulation, where advanced decomposition precludes detection of petechial hemorrhages and hemorrhages adjacent to fractures. The results show that mfCT was useful for identification of thin fracture lines in the fragile laryngeal structures. We suggest that mfCT should be considered for forensic autopsies in cases of suspected strangulation with advanced decomposition. [ABSTRACT FROM AUTHOR]

This paper presents a case of double murder in which different mechanisms of suffocation, involving smothering, burking, and manual strangulation, were used. The victims are usually elderly people with disabilities and social isolation. The cases described here involve two women who were disabled and were murdered through blockage of the airway. Even though similar suffocating mechanisms were used in the murders, the autopsy findings differed between the two cases. This difference between the two can be explained by a preexisting medical condition that the younger victim had, which was quadriplegia resulting from cerebral hemorrhage, which limited herself-defense ability.

Discovery of a fracture of the hyoid bone during forensic autopsy is a feature that raises suspicions of constriction of the neck. Studies have shown the influence of gender and build of the individual on the morphology of this bone. Our aims were to confirm these findings and to develop an experimental protocol for simulating manual strangulation in order to determine the force required to fracture the hyoid bone and the influence of anthropometric parameters on this force. A total of 77 intact hyoid bones were obtained, scanned, modeled, measured and embedded in resin. Using a hydraulic press, we applied force to the distal extremity of the greater horn. The relationships between the parameters of sex, weight and height of the subject, anteroposterior length of the hyoid, width between the greater horns, angle, fusion of the greater horns and force applied were analyzed. Our study confirmed sexual dimorphism, shown by greater length in males (>37.8 mm) than in females, and a larger angle in females (a shorter bone with a width > 43.7 mm and an angle > 31°01). The study confirmed the positive correlation between the length of the hyoid and the weight and height of the subject (p < 0.05). Sixty-seven of the 77 hyoid bones fractured during the experiment (87% fracture rate). Of the fractures, 48% occurred at the junction between the body and the greater horns, 49% in the greater horns (mean distance from the distal extremity of the horn 17.33 ± 4.37 mm), and 3% in the median part of the body. No significant association was found between gender and type of fracture, or between fusion or non-fusion of the horn (p > 0.05). Fused bones were not more susceptible to fracture than non-fused bones. Fracture occurred at a mean force of 30.55 N (±18.189). Multiple linear regression showed a significant negative correlation between force required for fracture and age, weight and height of the subject, anteroposterior length and angle. The younger the individual, the slighter their build, the longer the bone and the smaller the angle, the greater the force required to fracture the hyoid bone. [ABSTRACT FROM AUTHOR]

Post-mortem examination of a female homicide victim suggested a fracture of the larynx and increased flexibility, without associated hemorrhage, of the hyoid bone. There was a history of domestic violence, which included an allegation of attempted strangulation. Microscopy confirmed a recent fracture of the larynx and showed evidence of a healing fracture in the hyoid bone. Death was due to multiple blunt force trauma, including pressure to the neck. The deceased's partner admitted strangulation and was convicted of murder. The discussion concentrates on causation of laryngo-hyoid fractures and the potential usefulness of microscopy, particularly identifying evidence of previous trauma. [ABSTRACT FROM AUTHOR]

Copyright of Archiv für Kriminologie is the property of Schmidt-Roemhild Verlag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archiv für Kriminologie is the property of Schmidt-Roemhild Verlag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: A 21-year-old woman, who experienced manual strangulation, developed delayed parkinsonism associated with a selective symmetric basal ganglia lesion. The patient had recovered completely one year after early combination therapy. This case emphasizes the need for greater attention in detecting early brain injuries in those afflicted with strangulation so as to provide optimal management. [Copyright &y& Elsevier]

Introduction: This study aimed to evaluate the effect of manual strangulation of the uterine isthmus on the amount of blood loss during cesarean section., Material and Methods: This is a prospective randomized controlled trial. A total of 118 participants were enrolled in the study. Manual strangulation of the uterine isthmus just after placental removal was performed during cesarean section in group I ( n = 57; the strangulation group). Strangulation was not performed in group II ( n = 61; the control group). Preoperative and postoperative venous blood hemoglobin, capillary hemoglobin, and absorbed blood levels during the operation were compared between the two groups., Results: The median age of the patients was 28.5 (19-41). The median body mass index of the patients in the study was 27 (21-42). There were no significant differences in the demographic characteristics of the patients between the groups. The median difference between the preoperative and postoperative 4-6 h capillary hemoglobin values was significantly lower in the strangulation group (2.0 (0-9)) than in the control group (3.0 (0-8)). The amount of absorbed blood during the operation was also significantly lower in the strangulation group (164.5 ml (69-1310)) than in the control group (230 ml (35-3223))., Conclusions: Manual uterine strangulation of the uterine isthmus immediately after the removal of the placenta may induce a 30% decrease in blood loss during cesarean section., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2019 Termedia & Banach.)

We report the case of death of a 75-year-old Caucasian woman, produced by three different ways of mechanical asphyxia: smothering and strangulation by hand and traumatic asphyxia by thoracic compression. All these criminal offences were carried out by one single assailant who compressed the mouth and the nose of the victim with the left hand, squeezed her neck with the right hand and pressed her thorax with the knees. [Copyright &y& Elsevier]

Abstract: We present two cases of autopsy detection of laryngeal masses with medico-legal implications. The first is a 56-year-old man who died suddenly of asphyxia due to upper airway obstruction caused by a large glosso-epiglottic retention cyst and glottic oedema. Hypothesis of medical liability was raised, due to delayed tracheotomy as the result of repeated failed attempts at oral intubation by various physicians. Difficult oral intubation due to the presence of a laryngeal mass in an asphyxiating subject requires rapid tracheotomy. The second case deals with a 43-year-old woman who died of asphyxia due to airway obstruction, as a result of injury of a cavernous laryngeal haemangioma after homicidal manual strangulation, with severe haemorrhagic infiltration of the surrounding soft tissues. Damage to laryngeal/hypopharyngeal masses should be considered as a possible sign of manual strangulation, as well as neck skin bruises/abrasions and laryngeal haemorrhages. [Copyright &y& Elsevier]