[Unusual cases of self-asphyxiation]

Based on the description of the findings of four cases of self-strangulation with multiple knotting of the strangling device examined by the authors general criminological and specific forensic criteria for differential diagnosis of suicide and commission of the offence by another person are discussed. Though multiple knotting of the strangling device, caught hair and parts of clothes and concomitant injuries may also be seen in cases of suicide, they primarily justify the suspicion that the death was caused by another person. If it is one of those rare cases of self-strangulation with multiple knotting, the presence of symptoms of congestion in the head area, which may occasionally be absent in other cases of strangulation, is necessary for pathophysiological reasons.