Can MRI of the neck compete with clinical findings in assessing danger to life for survivors of manual strangulation? A statistical analysis.
OBJECTIVE
The aim of the study was to examine the clinical forensic findings of strangulation according to their ability to differentiate between life-threatening and non-life-threatening strangulation, compare clinical and MRI findings of the neck and discuss a simple score for life-threatening strangulation (SLS).


METHODS
Forensic pathologists classified a continuous sample of 56 survivors of strangulation into life-threatening cases by clinical history and examination alone. Subjective, objective and radiological signs were evaluated for discriminating the two groups.


RESULTS
In 27% of the cases life was in danger. The most significant signs of danger to life were congestive petechial hemorrhage in the face (eyes); hematoma of the neck and loss of consciousness. The radiological score could compete with the clinical scores.


CONCLUSIONS
Clinical forensic findings differ significantly in non-life-threatening and life-threatening manual strangulation. Thanks to MRI a rather objective test for life-threatening strangulation can be added to a SLS.
Christe
Andreas
A
Department of Radiology, Inselspital, University Hospital of Bern, Freiburgstrasse, 3010 Bern, Switzerland. andreas.christe@insel.ch
Oesterhelweg
Lars
L
Ross
Steffen
S
Spendlove
Danny
D
Bolliger
Stephan
S
Vock
Peter
P
Thali
Michael J
MJ
D000293:Adolescent; D000328:Adult; D001237:Asphyxia / Q000473:pathology*; D002648:Child; D003627:Data Interpretation, Statistical; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000175:diagnosis*; D018570:Risk Assessment / Q000379:methods*; D017741:Survivors; D015599:Trauma Severity Indices; D055815:Young Adult