An unusual, deep lingual hemorrhage as a consequence of ligature strangulation

During the course of the daily practice of forensic pathology, little or no attention is generally devoted to the tongue (if it is even removed at all during the autopsy examination) except in a handful of relatively well-defined situations. In some other instances, such as injuries involving the neck and laryngopharyngeal organs, the tongue may be removed, but examined in only a cursory manner, since the serious pathology which caused or contributed to death is most often located in adjacent structures. While the postmortem examination was being carried out on a victim of ligature strangulation who exhibited relatively sparse external and laryngeal findings of significance, a unique and apparently heretofore undescribed patterned hemorrhage was discovered within the deep musculature of the tongue, having an appearance and contour identical to that of the curved edge of the subjacent hyoid bone. In difficult cases where strangulation is suspected as well as other potentially medicolegal problems with trauma involving the neck organs, a detailed inspection of the tongue through an easily accomplished dissection technique may provide invaluable information as to the mechanism of injury.