In a case of ligature strangulation (homicide), which autopsy finding distinguishes it from hanging (typically suicidal)?

• A Presence of petechial hemorrhages in conjunctiva and skin
• B A horizontal, complete ligature mark at or below the thyroid cartilage level, with congested face and multiple pressure marks ✓
• C Fracture of the hyoid bone
• D Carotid sinus hemorrhage

Explanation

In ligature strangulation (homicidal), the ligature is typically applied horizontally (at the same level circumferentially, at or below the thyroid cartilage), the mark is complete (goes all the way around the neck), and the face shows congestion, cyanosis, and petechiae because venous return is obstructed while some arterial flow continues. In hanging (typically suicidal), the ligature mark is oblique (V-shaped, running upward toward the knot site), usually incomplete (absent at the knot point), and located high on the neck. Petechiae (A) can occur in both. Hyoid fracture (C) occurs in both but is more common in manual strangulation. Carotid hemorrhage (D) is non-specific.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.