Retrospective Analysis of Hanging Deaths in Ontario

Hanging deaths from investigation standpoint are rarely problematic. Unusual circumstances can on occasion raise suspicion of foul play. Associated neck injuries are reported in the literature with variable frequency (from 0% to 76.8%). This study retrospectively analyzed 755 hanging deaths in Ontario (Canada) to evaluate the demographic features and circumstances of hanging fatalities, and the frequency of hanging‐related neck injuries. A number of cases showed unusual/special circumstances (e.g., complex, double suicides, restraints). Among 632 cases with complete autopsies, hyoid and larynx fractures were present in 46 cases (7.3%) with the most common being isolated hyoid fractures. The incidence of cricoid fractures was 0.5% and cervical spine injuries, 1.1%. A higher incidence of neck injuries occurred among males, long drop hangings, and in cases with complete suspension. There was a tendency for the number of fractures to increase with increasing age and weight of the deceased.     

The diagnostic significance of haemorrhage of the posterior cricoarytenoid muscles

A number of authors have indicated that haemorrhage of the posterior cricoarytenoid (PCA) muscles can be used as a diagnostic criterion to establish the cause of death. Other authors even consider it to be 'forensic evidence' when differentiating between natural and violent death. They agree on agonal asphyxia or dyspnoea as a developmental mechanism, possibly in combination with a 'convulsive' dilatation of the glottic cleft. In view of this difference of opinion, we conducted a study of our own. Retrospective evaluation of 2060 post-mortem examinations performed in 1996 at the Institute of Forensic Medicine of the University of Munich disclosed 28 cases demonstrating visible haemorrhage of the PCA muscles. The study revealed no correlation between these findings and certain causes of death, nor any indication of certain mechanisms of development.