Judicial hanging: postmortem radiographic, CT, and MR imaging features with autopsy confirmation

Area of Science:

• Forensic Pathology
• Radiology
• Anatomy

Background:

• Judicial hanging is a method of execution.
• Understanding the specific injuries caused by judicial hanging is crucial for forensic investigations.

Purpose of the Study:

• To correlate postmortem radiologic and pathologic findings in two judicial hanging cases.
• To utilize modern imaging and autopsy techniques for detailed injury assessment.

Main Methods:

• Cervical spine radiography, CT scans (head, neck, chest), MR imaging (head, cervical spine), and vertebral angiography were performed.
• Complete autopsy with head and neck dissection followed imaging.

Main Results:

• Case 1 (subaural knot): Ligamentous injury, partial vertebral artery disruption, but no cord injury or subluxation.
• Case 2 (submental knot): Complete ligamentous disruption, C2-3 subluxation, and complete cervical cord transection.
• Both cases showed transverse process fractures and diffuse subarachnoid hemorrhage on CT/MR imaging.

Conclusions:

• Marked differences in injury extent and distribution were observed between the two cases.
• Case 1 likely resulted in death from cerebral anoxia/hypoxia, with loss of consciousness possibly due to subarachnoid hemorrhage.
• Case 2 involved severe spinal cord injury and subarachnoid hemorrhage.