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Symptoms and Physical Exam Findings in Sexual Assault-related Non-fatal Strangulation
Hannah H Spungen1, Karen M Bryan2, Carolyn J Sachs1,2
1UCLA Center for Health Sciences, Department of Emergency Medicine, Los Angeles, California.
The Western Journal of Emergency Medicine
|March 18, 2022
Summary
Many sexual assault survivors experiencing non-fatal strangulation (NFS) show no visible injuries, but neck and eye findings may indicate strangulation. Further research is needed to confirm causal links and long-term effects.
Area of Science:
- Forensic Medicine
- Trauma Research
- Sexual Assault Studies
Background:
- Non-fatal strangulation (NFS) during sexual assault presents unique challenges in forensic examination.
- Understanding the frequency and patterns of injuries is crucial for victim care and legal proceedings.
Purpose of the Study:
- To determine the occurrence of specific signs and symptoms after sexual assault-related NFS.
- To analyze the relationship between assault characteristics and physical examination findings.
Main Methods:
- Retrospective observational study of adults undergoing forensic sexual assault exams after reporting strangulation.
- Data abstracted from standardized forms included demographics, assault details, and physical findings.
- Descriptive statistics and chi-square tests were used for analysis.
Main Results:
- Of 580 subjects (99% female), neck (57.2%) and mouth (29.1%) were common injury sites.
- 19.1% had no evident injuries, and 29.8% reported loss of consciousness.
- Neck and eye/eyelid findings did not differ based on concurrent head trauma; only nose injury correlated with time to exam.
Conclusions:
- Visible neck injuries occurred in just over half of NFS victims; other non-anogenital injuries were less frequent.
- Head trauma may explain some non-anogenital injuries, but neck and eye findings may be specific to strangulation.
- Further research is required to establish strangulation as the cause and assess potential long-term neurological or vascular consequences.
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