title: The choking game: A deadly game. Analysis of two cases of "self-strangulation" in young boys and review of the literature.
abstract: The choking game is defined as a self-strangulation or strangulation by another person with the hands or a noose to achieve a brief euphoric state caused by cerebral hypoxia. Death may occur, but forensic pathologists often classify them as suicides or accidental deaths, without focusing on the possibility that they may result from a deliberate self-temporary-asphyxiation, turned into a deadly game. Presenting two fatal cases of self-strangulation involving an 11-year-old boy and a teenager of 15 years, the authors identify victims' characteristics and death scene's evidence, which may help to distinguish if a death is from an asphyxial suicide or an asphyxial game.
authors.affiliation: Department of Bio-Technologies and Life Sciences, Section of Forensic Pathology and Forensic Psychiatry, University of Insubria, Varese, Italy. Electronic address: laura.re@email.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Re
authors.affiliation: Department of Bio-Technologies and Life Sciences, Section of Forensic Pathology and Forensic Psychiatry, University of Insubria, Varese, Italy.
authors.forename: Jutta M
authors.initials: JM
authors.lastname: Birkhoff
authors.affiliation: Department of Bio-Technologies and Life Sciences, Section of Forensic Pathology and Forensic Psychiatry, University of Insubria, Varese, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Sozzi
authors.affiliation: Department of Bio-Technologies and Life Sciences, Section of Forensic Pathology and Forensic Psychiatry, University of Insubria, Varese, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Andrello
authors.affiliation: Department of Bio-Technologies and Life Sciences, Section of Forensic Pathology and Forensic Psychiatry, University of Insubria, Varese, Italy.
authors.forename: Antonio M M
authors.initials: AM
authors.lastname: Osculati
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction; D001237:Asphyxia / Q000503:physiopathology*; D002648:Child; D003643:Death; D006801:Humans; D008297:Male; D010988:Play and Playthings; D012309:Risk-Taking; D016728:Self-Injurious Behavior
keywords: Asphyxial game; Choking game; Jeu du foulard; Self-strangulation