title: Three different mechanisms of death: an unusual form of a child murder by asphyxia.
abstract: We report a very unusual case of murder of a 4-year-old male white child who died of asphyxiation. Asphyxia occurred due to 3 factors: manual strangulation, hyperextension of the neck, and atlantoaxial subluxation. The offenses were carried out by a single assailant (the stepfather of the child) who strangled the child with his right hand, using his left hand to pull the hair of the child, forcing the head back and causing hyperextension of the neck, thereby dislocating the first and second cervical vertebrae.
authors.affiliation: Hospital das Clínicas-São Paulo University School of Medicine, São Paulo, Brazil. miz@uol.com.br
authors.forename: Ivan Dieb
authors.initials: ID
authors.lastname: Miziara
authors.forename: Flavio
authors.initials: F
authors.lastname: Bertaccini
mesh_terms: D001237:Asphyxia / Q000209:etiology* / Q000473:pathology*; D001268:Atlanto-Axial Joint / Q000293:injuries / Q000473:pathology; D001929:Brain Edema / Q000473:pathology; D002675:Child, Preschool; D049429:Forensic Pathology; D006406:Hematoma / Q000473:pathology; D006470:Hemorrhage / Q000473:pathology; D006708:Homicide; D006801:Humans; D004204:Joint Dislocations / Q000473:pathology; D007830:Larynx / Q000473:pathology; D008297:Male; D019838:Neck Injuries / Q000473:pathology; D009334:Neck Muscles / Q000473:pathology