A triad of laryngeal hemorrhages in strangulation: a report of eight cases
Pollanen, MS
Department of Laboratory Medicine and Pathobiology, and the Forensic Pathology Unit, Office of the Chief Coroner for Ontario, Toronto, Ontario, Canada.


Abstract
The results of histological studies on larynges from eight cases of manual strangulation, all that had intracartilaginous laryngeal hemorrhages, a recently described and under-recognized lesion associated with strangulation, are reported. Formalin-fixed larynges were examined in serial section using a standardized protocol. In all cases, intracartilaginous laryngeal hemorrhages were associated with subepithelial laryngeal hemorrhages, and intralaryngeal muscular hemorrhages forming a “triad of hemorrhages.” In five cases, the triad was found in the presence of laryngeal cartilage microfractures. Since cartilage microfractures can be causally related to mechanical injury to the neck, it is likely that the triad of hemorrhages has diagnostic value as an independent morphological criterion for the postmortem diagnosis of strangulation. Since a proportion of cases of strangulation lack characteristics that are self-evidently due to violent application of pressure on the neck, recognition of the triad may have important implications for the postmortem diagnosis of strangulation.

Keywords:
asphyxia, forensic science, homicide, hyoid, larynx, petechial heorrhage, pressure on the neck, strangulation

Paper ID: JFS45318

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Author Pollanen MS Title A triad of laryngeal hemorrhages in strangulation: a report of eight cases Symposium , Committee on