Halskompression und arterielle Obstruktion

Abstract

Compression of the Neck and Arterial ObstructionSummary. Literature dealing with the obstruction of neck arteries induced by strangulation is referred to. Two types Of strangulation are applied to ten human corpses, i.e., hanging and strangulation by ligature. The neck arteries are isolated at their origins from the thoracic vessels. After removal of the brain the arterial openings at the skull base are observed of their flow through. Tap water is perfused through the vessels under four pressures, i.e., 100 , 200, 300, and 170 mm Hg. By using strangulation tools of three different diameters, various strangulation experiments are performed under controlled conditions imitating strangulation by ligature as well as atypical hanging. The most relevant results were:(1) In ~trangulation by ligature with the rope running horizontally round the neck it is possible to bring about obstruction to the carotid arterie~ by the same forces as in experimental hanging. Depending on the tool and on the arterial pressure, these forces vary between 2.5 and 10 kg. There are relations between the necessary forces, the diameter of the strangulaiion tools and the arterial pressures. Even by applying tractive forces in the range between 30-40 kg or by enhancing with a manual draw we did not succeed in bringing about an obstruction of the vertebral arteries. With the rope running obliquely round the neck as it does in typical hanging it is possible by minor tensile forces (between 8 and 17 kg) to obstruct these vessels as well.(2) In experimental hanging using a typical position of the tool, obstructions of all arteries occur between 5 and 15 kg. In types of hanging with an anterior suspension point above the level of the chin it was possible to occlude at least two vessels by application of intermediate forces.(3) In strangulation by ligature, the site of the appliance seems to have some influence. Infralaryngeal strangulation need somewhat greater tensile forces than a supralaryngeal course of the rope. Extreme bending of the neck does not impede the free passage of water, whereas with rotation and lateral flexion there could very well result obstructions of the arterial passage of the neck if physiological move of the head is reached or slightly overstepped.Some individual parameters of the corpses used (neck girth, rigor mortis, arteriosclerosis) did not have any influence on the powers obstructive to the carotid arteries.

Injuries due to Asphyxiation and Drowning

“…The arteriae vertebrales were furthermore not able to be closed even with loads of up to 35 kg with a horizontal ligature position. This result could be of significance for the blood stasis frequently observed in the head/neck region during throttling (Brinkmann et al 1981a).…”

“…Schwarzacher (1928) determined the minimal pulling force to achieve a perfusion stop to be 3.5 kg for the arteriae carotides communes and 16.6 kg for the arteriae vertebrales at an internal vessel pressure of 170 mmHg using a typical ligature position at the neck. In typical cases of hanging, Brinkmann et al (1981a) found closures of the arteriae carotides communes at pulling forces of 5-7 kg. Atypical ligature positions, for example with some of the loop between the lips and with knots at the side of the neck,…”

The course of respiration and circulation in death due to typical hanging

“…The vertebral arteries are not obstructed by compression of the horizontal part of the neck because they ascend through the foraminae in the transverse processes of the cervical vertebrae [2]. We could obstruct both vertebral arteries by exposing the vertebral column and ligating it with the rope running horizontally just below the bilateral transverse processes.…”

Carotis- und Vertebralisdurchblutung bei Unterarmw�rgen in der Dopplersonographie

“…5. Carotid sleeper gendem Strangwerkzeug (Brinkmann et al 1981), an der Atlasschlinge gelingt, kann beim Wtirgen mit dem Unterarm eine Kompression der Vertebralarterien nach ihrem Abgang aus der Subclavia auftreten.…”

“…Mit dieser Methode wurde auch in jfingerer Zeit die arterielle Durchblutung bei verschiedenen Formen des Angriffes gegen den Hals untersucht (Brinkmann et al 1981;Denk und Missliwetz 1988;Koops et al 1983). Die moderne bildgebende Diagnostik gibt die M6glichkeit, derartige Vorg~inge auch am Lebenden, unter realitfitsnahen, physiologischen Verhfiltnissen zu untersuchen.…”