Can MRI of the neck compete with clinical findings in assessing danger to life for survivors of manual strangulation? A statistical analysis

ObjectiveThe 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).Materials and methodsForensic 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.ResultsIn 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.ConclusionClinical 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.