Hanging

Hanging

This is defined as 'external compression of the neck by the weight of the suspension of an individual's head'. Hangings are overwhelmingly suicidal, but can be accidental (eg in autoerotic asphyxiation).

Hanging may occur with the body in the fully erect posture, with the feet clear of the floor, but this is not necessary - some individually hang themselves in the sitting or slumped position, where the suspension point is a door knob, or something at a similarly low level, rather than a tree branch or exposed beam etc.

Hangings that involve free swinging result in an almost instantaneous death due to sudden pressure on the neck arteries. If a long drop is involved, the cervical spine may be broken. (Judicial hanging resulted in death due to a broken cervical spine caused by a combination of the knot above the noose, the drop and the weight of the criminal).

Autopsy findings in hangings

ligature furrow on the neck coursing upwards towards the point of suspension. However this furrow may be absent if the ligature material is soft (eg a bed sheet), or where the deceased was cut down shortly after hanging him/herself, or where the body is decomposed. The furrow is usually above the level of the Adam's apple and becomes dried and parchmented after death.

congestion and petechiae of the head depend on the extent of body suspension - if the feet are off the ground the carotid arteries are likely to have been compressed, and the face is pale - if the body was fully supported on the ground, it is more likely that the jugular veins have been compressed but not the carotid arteries, and so the face would be intensely congested with many petechiae being present.

'stocking and glove' livor mortis distribution - if the body has been fully suspended/ hanging

bruising to the neck 'strap' muscles - immediately underlying the furrow (less likely with a 'soft' ligature)

fracture of the hyoid bone (this bone, you will recall from pre-clinical anatomy lectures, is that bone in the neck which acts as a sling supporting the tongue, and is the highest structure in the larynx) - this is only really a possibility in those with osteoporotic bones, and is more commonly a feature of manual strangulation where there is more of a 'pincer-type' action involved.

The usual suicidal hanging leaves an interrupted mark, rising to a peak - the point of suspension. However, if a slip knot is used, this peak may be absent, and the mark difficult to interpret in isolation of the features of the scene of death.

Hanging is usually suicidal, but some cases may be accidental, particularly those related to autoerotic asphyxiation.

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