Strangling

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Strangulation redirects here. For strangulation in medicine, see Strangulating.

Strangling is compression of the neck that leads to unconsciousness or death by causing an increasingly hypoxic state in the brain<ref name=ernoehazy>Ernoehazy, William; Ernoehazy,WS. Hanging Injuries and Strangulation. www.emedicine.com. URL last accessed March 3 2006.</ref>. Fatal strangling typically occurs in cases of violence, accidents, and as the mechanism of suicide in hangings. Strangling does not have to be fatal; limited or interrupted strangling is practiced in erotic asphyxia, in the choking game, and is an important technique and in many combat sports and self-defense systems (see Chokehold for further reading).

Strangling can be divided into three general types according to the mechanism used:<ref name=strack>Strack, Gael; McClane, George. How to Improve Investigation and Prosecution of Strangulation Cases. www.polaroid.com. URL last accessed March 3 2006.</ref>

Hanging — Suspension from a cord wound around the neck (see the separate article Hanging)
Ligature strangulation — Strangulation without suspension using some form of cord-like object
Manual strangulation — Strangulation using the fingers or other extremity

1 General
2 Manual strangulation
3 Ligature strangulation
4 See also
5 References

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General

Image:Internal carotid and vertebral arteries.jpg Strangling involves one or several mechanisms that interfer with the normal flow of oxygen into the brain:<ref name=jones>Jones, Richard. Asphyxia, Strangulation. www.forensicmed.co.uk. URL last accessed February 26 2006.</ref>

Compression of the carotid arteries and/or jugular veins — causing cerebral ischemia.
Compression of the laryngopharynx, larynx or trachea — causing asphyxia.
Stimulation of the carotid sinus reflex — causing brachycardia and/or hypotension.

Depending on the particular method of strangling, one or several of these typically occur in combination, but vascular obstruction is usually the main mechanism<ref name=ferris>Ferris, J.A.J. Asphyxia. www.pathology.ubc.ca. URL's last accessed March 1 2006 (DOC format)</ref>. Complete obstruction of blood flow to the brain is associated with irreversible neurological damage and death<ref name=koiwai2>Koiwai, Karl. How Safe is Choking in Judo?. judoinfo.com. URL last accessed March 3 2006.</ref>, but during strangulation there is still unimpeded blood flow in the vertebral arteries<ref name=reay>Reay, Donald; Eisele, John. Death from law enforcement neck holds. www.charlydmiller.com.URL last accessed March 3 2006</ref>. Estimations have been made that significant occlusion of the carotid arteries and jugular veins occurs with a pressure of around 3.4 N/cm², while the trachea demands six times more at approximately 22 N/cm²<ref name=gunther>Gunther, Wendy. On Chokes (Medical), with quotations from Spitz and Fisher's Medicolegal Investigation of Death: Guidelines for the Application of Pathology to Crime Investigation. www.aikiweb.com. URL last accessed March 3 2006.</ref>. As in all cases of strangulation, the rapidity of death can be affected by the suceptibility to carotid sinus stimulation<ref name=ferris/>. Carotid sinus reflex death is sometimes considered a mechanism of death in cases of strangulation, but it remains highly disputed<ref name=jones>Jones, Richard. Asphyxia, Strangulation. www.forensicmed.co.uk. URL last accessed February 26 2006.</ref><ref>Passig ,K. Carotid Sinus reflex death - a theory and its history. www.datenschlag.org. URL last accessed February 28 2006.</ref>. The reported time from application to unconsciousness varies from 8-14 seconds in effectively applied chokeholds<ref name=koiwai>Koiwai, Karl. Deaths Allegedly Caused by the Use of "Choke Holds" (Shime-Waza). judoinfo.com. URL last accessed March 3 2006.</ref> to one minute in some other cases, with death occurring minutes after unconsciousness<ref name=jones/>.

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Manual strangulation

Manual strangulation (in the UK called throttling and choking in the U.S.) refers to strangling with the hands, fingers or with other extremities (sometimes also with blunt objects such as batons). In violence, this type of strangling is mostly done by men against women rather than against another man, because it generally requires a large disparity in physical strength between the assailant and the victim.<ref name=jones/>. Depending on how the strangling is performed, it may compress the airway, interfer with the flow of blood in the neck or work as a combination of the two. Consequently, manual strangulation may damage the larynx<ref name=jones/>, and fracture bones in the neck<ref name=ferris/>. In cases of airway compression, manual strangling leads to the frightening sensation of air hunger and may induce violent struggling<ref name=jones/>. More technical variants of manual strangulation are referred to as chokeholds, and are extensively practised and used in various martial arts, combat sports, self-defense systems, and in military hand-to-hand combat application.

Image:GarroteExecution1901.jpg

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Ligature strangulation

Ligature strangulation refers to strangling with some form of cord or cloth such as rope, wire or shoe laces, either partially or fully circumferencing the neck<ref name=turvey>Turvey, Brent (1996). A guide to the physical analysis of ligature patterns in homicide investigations. Knowledge Solutions Library, Electronic Publication. www.corpus-delicti.com. URL last accessed March 1 2006.</ref>. Even though the mechanism of strangulation is similar, it is usually distinguished from hanging by the strangling force being some other than the persons own bodyweight<ref name=ferris/>. Incomplete occlusion of the carotid arteries is expected, and in cases of homicide, the victim may struggle for a period of time<ref name=ferris/>, with unconsciousness typically occurring in 10 to 15 seconds<ref name=turvey/>. Cases of ligature strangulation are generally involve homicides of women, children and elderly<ref name=ferris/>, but accidents and suicides occur as well <ref name=dundee>University of Dundee, Forensic Medicine. Asphyxial Deaths. www.dundee.ac.uk. URL last accessed March 3 2006.</ref>. Suicide by ligature strangulation requires that the constriction around the neck be held even after loss of consciousness<ref name=ferris/>, which can be accomplished with complicated knots<ref name=jones/>.