Monday 27 February 2012

Emedinews:Insights on Medicolegal issues: Autopsy findings in manual strangulation


Autopsy findings in manual strangulation

  • The autopsy findings fall into two groups: Local signs of violence, and the signs of the mechanism of death

  • Bruising on the neck is the result of the assailant’s attack, whereas abrasions may be from either the victim or assailant. The bruises are mainly discoid, but may run together into larger areas of neck bruising. The discoid marks are from finger-pads and are about 1-2 cm in size, though, longer, irregular marks may occur where the fingers skid across the skin surface, especially along the jaw margins. The bruises tend to cluster at the sides of the neck, often high up under the angles of the jaw. Some may overlap the jaw line and trespass on the chin, but others can be lower on the neck spreading down to the inner ends of the clavicles.

  • As a result of the shifting grip, often caused by the struggles of the victim, bruising can occur anywhere, even at the posterolateral sides of the neck, and on the upper chest over the sternum and collar bones. Some may be seen in the grooves on either side of the larynx, over the anterior edge of the stern mastoid. They are also common over the prominence of the larynx and at the level of the cricoid.

  • Abrasions on the neck: scratches may be caused by the assailant or the victim, usually from fingernails. As with bruising, rough finger pads, especially from a male hand on the delicate skin of a female neck, may abrade the epidermis and underlying bruises may be overlain by diffuse abrasions, again often seen along the margin of the jaw line.

  • Linear scratches are the hallmark of fingernails and when a woman strangles a child, the often longer nails of the woman may leave obvious marks. Whether male or female, the scratches are of two types: when the pressure is static, straight or curved marks up to a centimeter in length are made; when the nails skid down the skin, linear lines may result, sometimes several centimeters in length.

  • The alleged assailant should always be examined medically to correlate any injuries that may have been inflicted on him by the fingernails of the victim such as facial or hand scratches by the fingernails of the victim. If he/she is examined soon after the offence, his own fingernail scrapings should be taken, especially if the victim has neck abrasions, so that comparison studies can be made between any debris found and the tissue types of the victim.

(Ref: Bernard Knight Forensic Pathology 3rd edition)

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