Asphyxial Death: Hanging

• Hanging is that form of violent asphyxial deaths, which is

caused by the suspension of the body by a ligature which
encircles the neck, the constricting force being the weight
of the body.

Introduction
Depending on the degree of suspension:
A) Complete hanging: When the whole body is suspended
from the ligature material and no portion of the body is
touching the ground.
B) Partial hanging: As the name suggests, the body is
partially suspended, the toe or feet or either part of the
body touching the ground. The deceased may be in
kneeling down position, sitting position etc. here the
weight of the head is where the constricting force
comes from

Classification
Depending on position of the knot:
A) Typical hanging: Where the ligature runs from the
midline, above the thyroid cartilage, symmetrically
upwards on both sides of the neck, to the occipital
region and the knot is placed over the central part of the
back of neck.
B) Atypical hanging: The knot is anywhere other than the
central part of the back of neck

Classification
Depending on the manner of hanging:
A) Suicidal hanging.
B) Homicidal hanging.
C) Accidental hanging for e.g. autoerotic asphyxia.
D) Judicial hanging.

Classification
1. Asphyxia:
The ligature material’s constricting force causes
compressive narrowing of the larynx and the trachea, and
thereby forces up the root of the tongue against the posterior
wall of the pharynx, and folds the epiglottis over the
entrance of the larynx to block the airway. This obstruction
of the airway causes air hunger and if entry of air in the
lungs is completely prevented, then death occurs rapidly
with marked signs of asphyxia. A tension of 15kg on
ligature blocks the trachea.

Causes of death in hanging

2. Venous congestion
In cases, where the knot is situated in and around the chin
area, the venous flow is obstructed, but the arterial flow
remains intact. The jugular veins are involved, resulting in
stoppage of the cerebral circulation and a rapid rise in
venous pressure in the head leading to unconsciousness. A
tension of 2 to 3 kg is needed for such kind of incident.

Causes of death in hanging

3. Combined effect of asphyxia and venous congestion:
This is the commonest cause.
4. Cerebral anemia:
If the rope is situated at the nape of the neck, then both
arterial and venous blood flow are cut off by the pressure of
the noose on both sides of the neck. Pressure on the large
arteries produces cerebral anemia and immediate coma
within a short span of 10 to 15 seconds. A tension of 4 to 5
kg obliterates both the carotids and a tension of 20 kg is
needed for obliterating the vertebral arteries.

Causes of death in hanging

5. Reflex vagal inhibition :
Due to pressure over the carotid bodies or vagal sheath.
6. Fracture and dislocation of the cervical vertebra:
More commonly seen in judicial hanging.

Causes of death in hanging

1. If death occurs due to asphyxia, then the fatal period is
within 5 to 10 minutes. In case of death due to occlusion of
blood vessels, it takes a bit longer time- 12 to 20 minutes.
2. In judicial hanging, death is instantaneous.
3. Delayed deaths: Delayed death by several days is rare and
occurs due to-
1) aspiration pneumonia,
2) infections,
3) edema of larynx or lungs,
4) infarction of brain,
5) hypoxic encephalopathy,
6) brain abscess

Fatal Period :
• Externally the appearance of the ligature mark is the most
important finding and specific sign of death by hanging.
The ligature mark on the neck depends on :
1) Composition of the ligature: That involves the pattern
and texture of the ligature mark produced upon the skin. If a
nylon rope with patterns used as a ligature material, then the
same may be seen as a patterned abrasion over the neck.
The pattern abrasion may not be that visible, if a soft and
broad material is being used as ligature.

Post Mortem Appearance

2) Width and multiplicity of the ligature: Sometimes a
single ligature mark may be produced, and sometimes
multiple turns of ligature may be produced if double turns
of ligature applied over the neck. If a narrow ligature
material is used, then grooving is more as much more force
is used per square metre of the area, and if a soft broad
material is used, then only a superficial mark is being
produced.

Post Mortem Appearance

3) The weight of the body and the degree of suspension: The
heavier the body, and more the time of suspension, the more
marked will be ligature mark.
4) Length of time the body has been suspended: As it suggests,
the longer the body is suspended, the more marked will be the
ligature mark. Thus a broad ligature material can also produce a
marked ligature impression if the suspension time is more and a
thin ligature material may not produce a grooving, if the body is
brought down within a short period of time. Incidentally, if a soft
and broad ligature material used, and body is also brought down
within a short span of time, then very faint external mark may be
produced.

Post Mortem Appearance

5) Position of the knot: It is important to comment upon the
position of the knot, if it’s present in situ. The main force
applied is usually opposite to the point of suspension.

6) Slipping of the ligature mark: There is tendency of the

ligature mark to slip upwards, which may be limited by the
jaws. This upward movement may produce double
impression of the ligature and in that case. The lower mark
is very superficial and is connected by abrasions produced
during slipping movement.

Post Mortem Appearance

• 7) Knot mark: The location and the type of the knot mark
is being recorded. It has to be noted whether the ligature
is below the chin, below the ear or at the nape of the
neck. This produces an inverted “V” shaped ligature
mark, corresponding to the site of the knot. The knot may
be a fixed type of knot or running type of knot.
• 8) Removal of the ligature material: The knot should
never be opened for removing the ligature material. The
first step is to take photograph before removal of the
ligature material. The ligature is now cut opposite the
knot and the two cut ends are secured with a string.

Post Mortem Appearance

Ligature Mark
 Hanging is that form of violent asphyxial deaths, which is caused
by the suspension of the body by a ligature which encircles the
neck, the constricting force being the weight of the body.
 The causes of death due to hanging include: Asphyxia, Venous
congestion, Cerebral anemia, Reflex vagal inhibition, Fracture and
dislocation of the cervical vertebra.
 In case of post mortem appearance the appearance of the ligature
mark is the most important finding and specific sign of death by
hanging.
 In infants and obese persons, the skin folds of the neck may look
like a ligature mark.
 Post mortem staining: is seen on forearms, arms, legs, feet, soles
and is known as “glove and stocking like distribution” as they
become the dependent areas due to suspension of the body.
 Hanging is invariably suicidal, until unless otherwise proved. In a
suicidal hanging, any material available at that moment of time can
be used for the act.
 Homicidal hanging is very difficult to establish until unless the
person is under the influence of any drugs or alcohol or is a mere
child or weak and feeble individual.
 In some countries, including India, hanging is the mode of carrying
out capital punishment or legal execution of death sentence.

Summary