Absence of haemorrhagic infiltration and the value of cervical injuries in mechanical asphyxia caused by neck compression

01 / Abstract

Context and purpose.

In medico-legal practice, haemorrhage in the soft tissues of the neck is often interpreted as evidence of compression during life, while its absence may be used incorrectly to question the vitality of a hanging or strangulation. The relationship is not symmetrical: genuine traumatic haemorrhage with a concordant distribution is positive evidence, but the absence of haemorrhage has limited exclusionary value.

This paper distinguishes hanging, ligature strangulation and manual strangulation, reviews injuries to cervical structures and examines the influence of dissection, resuscitation and post-mortem artefacts. Diagnosis should not rest on a single sign, but on convergence between scene findings, morphology, examination technique, histology and alternative explanations.

02 / Key findings

Conclusions to retain.

1. 01Absence of haemorrhagic infiltration beneath the ligature mark is compatible with a vital and fatal hanging.
2. 02Genuine cervical haemorrhage supports trauma, but is not specific to one mechanism or manner of death.
3. 03Fractures of the hyoid and laryngeal cartilages must be interpreted in relation to age, ossification, distribution and context.
4. 04Layered cervical dissection in as bloodless a field as possible improves sensitivity and limits artefactual haemorrhage.

03 / Structure

What the paper examines.

1. 01Purpose and terminology
2. 02Cervical haemorrhage and vitality: asymmetric evidential value
3. 03Why infiltration may be absent after vital compression
4. 04Post-mortem pitfalls, resuscitation and dissection artefacts
5. 05Medico-legal value of absent haemorrhage
6. 06Injuries to cervical tissues and anatomical structures
7. 07Indicative differences between compression mechanisms
8. 08Autopsy technique and complementary investigations
9. 09A weight-of-evidence interpretation model
10. 10Comparative table and recommended wording
11. 11Conclusions and selected references

04 / Full paper

Read or download.

The complete scientific paper, including its tables, conclusions and references, is available in Romanian.

05 / Citation and use

Suggested reference.

Chiriac S. Absence of haemorrhagic infiltration and the value of cervical injuries in mechanical asphyxia caused by neck compression. Critical medico-legal review. September 2026.

Scientific and educational review material. Substantial reproduction requires acknowledgement of the source; conclusions must be interpreted in the full context of the paper and its references.