Medical evidence assisting non-fatal strangulation prosecution: a scoping review

Sharman, Leah; Fitzgerald, Robin; Douglas, Heather

doi:10.1136/bmjopen-2023-072077

Cited by 8 publications

(3 citation statements)

References 45 publications

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“…In congruence with previous studies [ 33 ], the number of subjective symptoms reported by the victims did not correlate significantly with the number of MRI findings. This underlines that most symptoms highly depend on the subjective perception of the victim.…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Longitudinal visibility of MRI findings in living victims of strangulation

Bauer,

Hollenstein,

Lieb

et al. 2024

Int J Legal Med

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Initial experiences with magnetic resonance imaging (MRI) of living strangulation victims demonstrated additional findings of internal injuries compared to the standard clinical forensic examination. However, existing studies on the use of MRI for this purpose mostly focused on the first 48 h after the incident. The aims of this study were (a) to evaluate the longitudinal visibility of MRI findings after violence against the neck by performing two MRI examinations within 12 days and a minimum of four days between both MRI scans and (b) to assess which MRI sequences were most helpful for the detection of injuries. Twenty strangulation victims participated in this study and underwent one (n = 8) or two (n = 12) MRI scans. The first MRI examination was conducted during the first five days, the second five to 12 days after the incident. Two blinded radiologists assessed the MRI data and looked for lesions in the structures of the neck. In total, 140 findings were reported in the 32 MRI examinations. Most of the findings were detected in the thyroid and the muscles of the neck. T2-weighted SPACE with fat suppression, T1-weighted TSE and T1-weighted MPRAGE were rated as the most helpful MRI sequences. Subjects who showed findings in the initial scan also demonstrated comparable results in the second scan, which was performed on average 8.4 days after the incident. Our results show that even up to 12 days after the incident, the criminal proceeding of strangulation cases may greatly profit from the information provided by an MRI examination of the neck in addition to the standard clinical forensic examination.

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Section: Discussionsupporting

confidence: 90%

“…The most common categories of external injuries in our study, i.e. abrasions, erythema and bruises, corresponded well with literature [33]. However, the number of external findings did not correlate with the number of MRI findings, with more findings found internally than externally.…”

Section: Discussionsupporting

confidence: 89%

Longitudinal visibility of MRI findings in living victims of strangulation

Bauer,

Hollenstein,

Lieb

et al. 2024

Int J Legal Med

View full text Add to dashboard Cite

show abstract

“…The experimental model ultimately concluded that the amount of force applied, irrespective of the victim's attempts at self-defense, exceeded 5 kg, and was enough to cause blood vessels in the neck to constrict [10][11][12][13][14]. These findings were presented in Court as scientific evidence that the manner and force of the strangulation were indeed consistent with an attempted murder [15][16].…”

Section: Outcome Of Strangulationmentioning

confidence: 99%

Reconstruction of Trauma Dynamics Due to Ligature Strangulation by Using a Dynamometer: A Technical Report

Sacco,

Ricci,

Fragomeni

et al. 2023

Cureus

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Asphyxiation caused by violence, particularly through ligature strangulation, necessitates the application of a force that is characterized by a point of application, direction, and intensity. These properties can be quantified through the use of a dynamometer, which is composed of a graduated scale and a spring. In this particular study, an experimental model utilizing a dynamometer was employed to aid in the diagnosis and analysis of the dynamics of violent trauma resulting from homicidal ligature strangulation. The experimental model was applied to an attempted murder case involving strangulation. The primary challenge in this case was to establish the attempted murder scientifically, as the offender claimed that there had been no intent to kill, but instead an attempt to frighten the victim. To prove his assertion, the assailant emphasized the absence of strangulation injuries on the victim's neck. To investigate, a crane scale dynamometer was fixed on a cable and placed on a manikin's neck. The potential measurable combinations with the dynamometer were then compared to witness accounts and the injuries found on the victim. The utilization of a dynamometer in our case permitted the diagnosis and verification of a trauma that was undoubtedly caused by violent asphyxiation via strangulation. The information yielded by the dynamometer was subsequently submitted as scientific evidence in Court, serving to substantiate the intent to commit homicide and substantiate the credibility of the victim's testimony.

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Examining the use of alternative light sources in medico-legal assessments of blunt-force trauma: a systematic review

Tyr,

Heldring,

Zilg

2024

Int J Legal Med

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The ability to analyze blunt-force trauma is crucial for deciphering valuable clues concerning mechanisms of injury and as evidence for medico-legal investigations. The use of alternate light sources (ALS) has been studied over the past decade, and is proposed to outperform conventional white light (CWL) during bruise assessments. In response to the growing interest of the technology worldwide, a systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) to address the ability of ALS to detect and visualize bruising. From an initial 4055 records identified, ten studies met the eligibly criteria and were selected for this review. Evaluation also included a novel framework, referred to as SPICOT, to further systematically assess both scientific evidence and risk of bias in forensic literature. Analysis reveals that narrowband wavelengths within in the infrared or ultraviolet spectral ranges do not significantly outperform CWL in visualizing or detecting bruising. However, wavelengths within the visible spectrum, particularly 415 nm combined with longpass or bandpass yellow filters, are more effective. However, the majority of selected studies only address the sensitivity of ALS, and therefore, results may only be considered valid when the location of a bruise is known. Further investigation is required to understand the specificity of ALS, in particular how the use of topical cosmetic products, previous wounds/scar-tissue, tattoos, moles and freckles may affect detection. The ethical concern regarding the interpretation of enhanced visualized trauma should also be considered in prospect discussions prior to implementing ALS into routine practice. Nevertheless, this review finds that narrowband ALS within the visible spectrum demonstrates potential for improved injury documentation, outperforming CWL in the detection and visualization of bruising.

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Medical evidence assisting non-fatal strangulation prosecution: a scoping review

Cited by 8 publications

References 45 publications

Longitudinal visibility of MRI findings in living victims of strangulation

Longitudinal visibility of MRI findings in living victims of strangulation

Reconstruction of Trauma Dynamics Due to Ligature Strangulation by Using a Dynamometer: A Technical Report

Examining the use of alternative light sources in medico-legal assessments of blunt-force trauma: a systematic review

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