The document discusses strangulation, its types, postmortem findings, causes of death, and its medico-legal implications. It categorizes strangulation into various forms, such as manual, ligature, and mechanical, explaining the differences in findings between strangulation and hanging. It also details the signs of struggle, the characteristics of injuries, and provides insights into the likelihood of homicidal, accidental, or suicidal strangulation.

1. Strangulation
Dr. Md. Iqbal Bahar
Chowdhury
Associate Professor ,
SMAMC

2. Objectives
After this class you will be able to know about-
 Strangulation and its types
 Postmortem findings of strangulation & throttling
 Causes of death due to strangulation
 Difference between hanging from strangulation &
postmortem suspension
 Medicolegal importance & opinion of strangulation

3. Strangulation
 Strangulation is that form of violent
asphyxia
 which is caused from constriction of the
neck
 by a ligature or any other mechanical
means
 without suspending the body.
 The constricting force being other than the
weight of the body.

4. Types
1) Strangulation proper:
-Ligature strangulation.
2. Manual strangulation:
-Throttling.
3. Mechanical:
-Bansdola
-Mugging
-Garroting

5. Post mortem findings
External:
1.In the face-
Cyanosed, swollen
Protrusion of eye ball & tongue
Tardieu’s spot are seen in the
conjunctiva, eyelids.
Bleeding from nose may be present.

6. External findings

7. External findings

8. Cont..
2. In the neck-
Ligature mark- transverse, circular
or continuous & below the thyroid
cartilage
The base of the ligature mark is red,
abrasion & bruise may be present.

9. Cont..
Tardieu’s spot will be more marked
just above the ligature mark
There may be scratch marks are
seen on the skin near the ligature
mark.

11. Cont..
3. General Findings-
 Post mortem staining-Deep bluish or
reddish purple in color
 There may be general violence due to
struggle.
 There may be involuntary discharge-urine,
stool, semen etc.
 There may cadaveric spasm with foreign
materials found.

12. Cont..
Internal:
1.In the neck-
The skin is show marked bruise &
hemorrhage.
Deep muscles of the neck are grossly
bruised.
Fracture of the thyroid cartilage is
commonly seen.

13. Cont..
2. Internal organ-
- Trachea & larynx are congested.
- Lungs are congested & Petechial
hemorrhage may present.
- Brain & meninges are also congested.
- All internal organs are congested.

14. Causes of death
1. Asphyxia
2. Cerebral venous congestion or
apoplexy
3. Cerebral anoxia
4. Combined asphyxia & venous
congestion
5. Vagal inhibition

15. Medico-legal Importance
Homicidal: most common methods
all over the world.
Accidental: accidental strangulation
commonly seen in children, cord
around the neck in case of fetus
Suicidal ???

16. Accidental strangulation

17. Traits Hanging Strangulation
Ligature mark Oblique, non
continuous, high up.
Transverse, continuous,
low down
Dribbling of Saliva Present Usually absent.
neck Stretched & elongated Not stretched &
elongated
Hyoid bone Fracture is common Fracture is uncommon.
Thyroid
cartilage
Fracture is less
common.
Fracture is very
common.
Carotid arteries Damage may be seen Damage is very rare.
Seminal fluid At glans is more
common
At glans is less
common.

18. Traits Hanging PM Suspension
Tardieu’s spot Present above the
ligature mark
Absent
Parchmentization Present Absent
Saliva Present Absent
Semen, blood,
urine, feces
Present Absent
Vital sign in
neck tissue
present Absent

19. Medico legal Opinion of
Strangulation
In my opinion, death was due to
asphyxia as a result of
strangulation which was ante-
mortem and homicidal in nature.

20. Mugging(Arm locks)
Mugging is a form of strangulation caused
by holding the neck of the victim in the
bend of the elbow.
Character:
 The attack is usually made from behind.
 There will be no ligature mark as soft
tissue of the elbow act as constriction
force.
 There are external sign of struggle
present.

21. Mugging

22. Choke hold Carotid Sleeper

23. Bansdolla
 It is a form of strangulation in which
compression of the neck in between two
sticks one is in front of neck another on
the back.
Character:
 A linear bruise or injury is seen in front of
the center of the neck which does not
follow the curvature of the neck
 Bruise & abrasion also seen at the back of
the neck.

24. Garroting
 It is a form of strangulation in which a
ligature is thrown over the neck of the
unaware victim from the back & rapidly
twisted the ligature with a lever.
Character:
 A transverse circular ligature mark is
found.
 There will be no sign of struggle mark
due to sudden unconsciousness.
This method is used as death sentence in Spain.

25. Throttling/Manual strangulation
 It is a form of strangulation in which the
palm or fingers of the hand used to
compress the front of the neck of the
victim.
Cause of death;
 Asphyxia
 Sudden cardiac arrest by Reflex vagal
inhibition

26. Post mortem appearance
A. External:
 There are scratches & bruise caused by nail
& fingertips is found.
 Crescentic finger nail marks-
1. If one hand is used, thumbnail impression is
seen on one side of the neck & other four
fingernail marks are seen on the other side
of the neck.

27. External findings

28. Cont..
2. When both hands are used,
thumbnail impression of both hands
will be in the middle, with rest of
the four fingers nail marks are seen
on either side of the neck, as one
thumbnail mark & finger nails marks
of another hand is noticed on each
side of the neck.

29. Cont..
B. Internal:
 Bruise may be seen over the prominence
of the larynx & at the level of cricoid
cartilage.
 There are diffuse extravasations of blood
in the soft tissue.
 Lungs are congested.
 Brain& Meninges are congested.
 All internal organs are congested.

30. Is suicidal throttling is
possible?
No, because the compression of the neck as
larynx & trachea produces rapid unconsciousness
there by fingers will be relaxed.

31. Medico-legal Importance
 Homicidal: most common method to
commit homicide in case of old, children,
intoxicated person.
 Accidental: may be occur when one
playfully holding other’s neck for fun.
 Suicidal: not possible.

32. Long scarf syndrome

33. Pseudo-strangulation mark

34. Reference
 The Essentials Of Forensic Medicine And
Toxicology by Dr. K. S. Narayan Reddy
 Principles of Forensic Medicine:
Including Toxicology by Apurba Nandy
 Lecture from Sir Salimullah Medical
College by Prof. Dr. T.C. Das

36. Thank You