Pericarotid bone splinter: a microscopic appearance in hanging

The investigation of the neck structures drawn from 145 cases of asphyxia involving pressure on the neck, for which microscopic examination was required at the Pathology Laboratory of the "Hotel Dieu" Hospital from Lyon, France, during January 1, 1999, to May 1, 2001, has pointed out in 3 cases, besides the classic signs already known, a particular lesion unmentioned yet in the literature, namely, a pericarotid bone splinter, placed in the proximity of the common carotid artery bifurcation. The bone splinters had dimensions between 0.25 and 0.7 mm and a certain antemortem character, surrounded by hemorrhagic areas and by fibrin. The 3 cases deal with adult males who had died through complete hanging, with the knot placed lateral, the hanging mark having the maximum depth in the laterocervical region, correspondent with our finding. Given the location of the bone splinter, we believe that this was produced by the tearing out from the transverse apophysis of the fourth cervical vertebra, as a consequence of the sudden traction during hanging. This sign appeared neither at other types of hanging nor at strangulation by hand or by ligature.