A ligature mark is found encircling the neck of a deceased. The mark is at the level of the thyroid cartilage, is oblique (upward toward the knot), does not completely encircle the neck, and shows a gap posteriorly. Which manner of death does this pattern indicate?

• A Homicidal strangulation
• B Atypical suicidal hanging ✓
• C Typical suicidal hanging
• D Ligature strangulation (manual throttling variant)

Explanation

In typical hanging, the ligature mark is oblique, placed above the thyroid cartilage, directed upward toward the point of suspension, incomplete (gap at the suspension point), and pale/parchment-like (due to pressure anoxia). Atypical hanging occurs when the point of suspension is low (e.g., door handle) and the body is partially supported; the mark pattern is the same as typical hanging but the position is atypical. Homicidal strangulation shows a horizontal, complete, lower ligature mark at or below the thyroid cartilage with finger-nail abrasions nearby.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

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Written and medically reviewed by the StethoPrep medical team.