Strangulation-Manual neck compression General aspects, pathophysiology, criminalistic circumstances and autopsy findings

Manual strangulation is one of the most common methods of deliberate homicide. Strangulation is often the first but not the only act of aggression. Other forms of traumatization frequently applied in combination with manual neck compression include ligature strangulation as well as the use of blunt and sharp forces. The pathophysiology of obstructive asphyxia and specifically of manual strangulation is briefly reviewed in this CME article and related to the autopsy findings with a focus on the external and internal injuries in the cervical region and the signs of venous blood congestion. Special attention is paid to the circumstances of the case and to assaults to the neck which leave only sparse traces.