Histopathological Analysis of Neck Muscles in Suicidal Hanging: A One-year Prospective Study
Keywords:
Hanging, Suicide, Autopsy, Anterior neck muscles, HistopathologyAbstract
Hanging is the most common way used to commit suicide in India. The ligature mark is the main finding at the external examination, but the internal neck examination shows a very few visible findings on the gross examination. This study aimed to compare between gross features and histopathological findings in neck tissue and to analyze various micro scopic findings such as congestion, hemorrhage, muscle fiber breakdown, and leukocyte infiltration in the mylohyoid, sternohyoid, and sternocleidomastoid muscles. A total of 34 cases of suicidal hanging were taken for the study. There is a significant difference between gross features and histopathological findings in neck tissue. The congestion was found in sternohyoid and sternocleidomastoid muscles in 18 cases (52.94%) and 15 cases (44.11%), respectively, and was less evident in mylohyoid muscle only in 9 cases (26.47%). The hemorrhages were found in the sternocleidomastoid muscle in 16 cases (47.05%), in the sternohyoid muscle in 9 cases (26.47%), and in the mylohyoid muscle in 3 cases (8.82%). The muscle fiber breakdown was present in sternocleidomastoid muscle in 19 cases (55.88%), in sternohyoid muscle in 16 cases (47.05%), and mylohyoid in 11 cases (32.35%). The leukocyte infiltration is seen in only one case in the ster nohyoid muscle. All the above findings were absent only in 4 cases (11.76%). Microscopic examination, particularly of anterior neck muscles, can become significant evidence of the antemortem nature of hanging in cases when gross vital signs are absent.
References
1. Knight, B., & Saukko, P. (2016). Fatal pressure on neck. In Knight’s forensic pathology (4th ed., pp. 369–397). Boca Raton, FL: CRC Press.
2. DiMaio, V. J., & DiMaio, D. (2001). Forensic pathology (2nd ed., pp. 260–275). London: CRC Press.
3. National Crime Records Bureau. (2022). Accidental deaths & suicides in India. New Delhi: Ministry of Home Affairs. Available at: https://ncrb.gov.in/uploads/nationalcrimerecordsbureau/custom/adsiyearwise2022/170161093707Chapter-2Suicides.pdf [Accessed 21 September 2024].
4. Maxeiner, H. (1987). Zur lokalen Vitalreaktion nach Angriff gegen den Hals. Zeitschrift für Rechtsmedizin, 99, 35–54.
5. Sigrist, T., & Germann, U. (1989). Tötung durch Ersticken – ja oder nein? Zeitschrift für Rechtsmedizin, 102, 549–557.
6. Jiwane, A. S., Zine, K. U., & Bardale, R. V. (2021). Microscopic analysis of compression injury over neck: One-year prospective study. Indian Journal of Forensic and Community Medicine, 8(2), 125–131.
7. Sharma, B. R., Harish, D., Sharma, A., Sharma, S., & Singh, H. (2008). Injuries to neck structures in deaths due to constriction of neck, with a special reference to hanging. Journal of Forensic and Legal Medicine, 15(5), 298–305.
8. Ambade, V. N., Kolpe, D., Tumram, N., Meshram, S., Pawar, M., & Kukde, H. (2015). Characteristic features of hanging: A study in rural district of Central India. Journal of Forensic Sciences, 60(5), 1216–1223.
9. Yadav, A., & Gupta, B. M. (2011). Histopathological changes in skin and subcutaneous tissues at ligature site in cases of hanging and strangulation. Journal of the Indian Academy of Forensic Medicine, 31(3), 200–205.
10. Jayaprakash, S., & Sreekumari, K. (2012). Pattern of injuries to neck structures in hanging – An autopsy study. American Journal of Forensic Medicine and Pathology, 33(4), 395–399.
11. Naik, S. K., & Patil, D. Y. (2005). Fracture of hyoid bone in cases of asphyxial deaths resulting from constricting force round the neck. Journal of the Indian Academy of Forensic Medicine, 27(3), 149–153.
12. Advenier, A. S., & de la Grandmaison, G. L. (2014). Traumatic rupture of deep neck structures in hanging: Two case reports. American Journal of Forensic Medicine and Pathology, 35(3), 189–192.