Pericarotid bone splinter: a microscopic appearance in hanging

Area of Science:

• Forensic Pathology
• Forensic Medicine
• Toxicology

Background:

• Asphyxia involving neck pressure is a significant cause of death.
• Microscopic examination of neck structures is crucial for determining cause of death.
• Existing literature lacks detailed descriptions of specific bone lesions in certain hanging types.

Purpose of the Study:

• To identify and characterize novel lesions in neck structures resulting from asphyxia.
• To investigate the potential diagnostic significance of newly found bone splinters in forensic cases.
• To differentiate between various forms of neck strangulation based on pathological findings.

Main Methods:

• Retrospective analysis of 145 cases of asphyxia involving neck pressure.
• Microscopic examination of neck structures at the Pathology Laboratory of "Hotel Dieu" Hospital.
• Detailed documentation of bone splinter characteristics, including size and antemortem indicators.

Main Results:

• A previously undescribed pericarotid bone splinter was identified in 3 out of 145 cases.
• These bone splinters, measuring 0.25–0.7 mm, exhibited antemortem characteristics with surrounding hemorrhage and fibrin.
• The finding was exclusively observed in adult males who died from complete hanging with a lateral knot, correlating with laterocervical injury depth.

Conclusions:

• The pericarotid bone splinter likely originates from the transverse apophysis of the fourth cervical vertebra due to sudden traction in hanging.
• This specific bone splinter is a unique indicator for complete hanging with a lateral knot, distinguishing it from other hanging types and strangulation.
• The discovery provides a novel, specific postmortem sign for forensic investigations of hanging deaths.