Histological examination of carotid artery tissue in cases of ligature strangulation and hanging
Violence against the neck can result in a range of macromorphological and micromorphological findings. However, the forensic relevance of the carotid sinus in cases of violence against the neck remains controversial. In this follow-up study of 22 cases of suicidal and accidental strangulations, caro...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Oxford University Press
2022-03-01
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| Series: | Forensic Sciences Research |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/20961790.2022.2034715 |
| _version_ | 1827834489554862080 |
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| author | Julia Ulbricht Burkhard Madea Elke Doberentz |
| author_facet | Julia Ulbricht Burkhard Madea Elke Doberentz |
| author_sort | Julia Ulbricht |
| collection | DOAJ |
| description | Violence against the neck can result in a range of macromorphological and micromorphological findings. However, the forensic relevance of the carotid sinus in cases of violence against the neck remains controversial. In this follow-up study of 22 cases of suicidal and accidental strangulations, carotid bifurcations were examined histologically for morphological changes implying direct trauma, including haemorrhage and immunohistochemical expression of heat-shock proteins 27, 60, and 70 and aquaporin-3. These cases were compared with a control group (82 cases) without neck compression or head trauma and with variable causes of death. No relevant histopathological findings implying direct trauma of the carotid bifurcation were found. No cases showed positive aquaporin-3 staining and only five cases showed positive heat-shock protein-27 staining, all of which were hangings. Without massive trauma of the carotid bifurcation, histological alterations cannot be expected. Without signs of rapid death, findings of acute circulatory failure, macromorphological and micromorphological findings of neck compression, and reliable markers indicating relevant impact on the carotid bifurcation the diagnosis of a lethal reflex cannot be verified.Key pointsAmong 22 cases of strangulation causing death, there were 16 cases of hanging and 6 cases of ligature strangulationFew cases showed small haemorrhages located predominantly in the surrounding fat and connective tissues; however, the haemorrhages did not have any effects on the tissuesNeck compression had minimal effects on heat shock protein 27 expression in carotid artery tissueAquaporin-3 staining suggested it is not a useful marker for relevant neck pressure, or that there had not been any relevant neck impactOur findings suggested no direct evidence for reflex cardiac death resulting from a brief force against the neck |
| first_indexed | 2024-03-12T05:51:33Z |
| format | Article |
| id | doaj.art-749eba30a28f47db84077f5cd49a2160 |
| institution | Directory Open Access Journal |
| issn | 2096-1790 2471-1411 |
| language | English |
| last_indexed | 2024-03-12T05:51:33Z |
| publishDate | 2022-03-01 |
| publisher | Oxford University Press |
| record_format | Article |
| series | Forensic Sciences Research |
| spelling | doaj.art-749eba30a28f47db84077f5cd49a21602023-09-03T05:06:27ZengOxford University PressForensic Sciences Research2096-17902471-14112022-03-0111110.1080/20961790.2022.2034715Histological examination of carotid artery tissue in cases of ligature strangulation and hangingJulia Ulbricht0Burkhard Madea1Elke Doberentz2Institute of Legal Medicine, University Hospital Bonn, Bonn, GermanyInstitute of Legal Medicine, University Hospital Bonn, Bonn, GermanyInstitute of Legal Medicine, University Hospital Bonn, Bonn, GermanyViolence against the neck can result in a range of macromorphological and micromorphological findings. However, the forensic relevance of the carotid sinus in cases of violence against the neck remains controversial. In this follow-up study of 22 cases of suicidal and accidental strangulations, carotid bifurcations were examined histologically for morphological changes implying direct trauma, including haemorrhage and immunohistochemical expression of heat-shock proteins 27, 60, and 70 and aquaporin-3. These cases were compared with a control group (82 cases) without neck compression or head trauma and with variable causes of death. No relevant histopathological findings implying direct trauma of the carotid bifurcation were found. No cases showed positive aquaporin-3 staining and only five cases showed positive heat-shock protein-27 staining, all of which were hangings. Without massive trauma of the carotid bifurcation, histological alterations cannot be expected. Without signs of rapid death, findings of acute circulatory failure, macromorphological and micromorphological findings of neck compression, and reliable markers indicating relevant impact on the carotid bifurcation the diagnosis of a lethal reflex cannot be verified.Key pointsAmong 22 cases of strangulation causing death, there were 16 cases of hanging and 6 cases of ligature strangulationFew cases showed small haemorrhages located predominantly in the surrounding fat and connective tissues; however, the haemorrhages did not have any effects on the tissuesNeck compression had minimal effects on heat shock protein 27 expression in carotid artery tissueAquaporin-3 staining suggested it is not a useful marker for relevant neck pressure, or that there had not been any relevant neck impactOur findings suggested no direct evidence for reflex cardiac death resulting from a brief force against the neckhttps://www.tandfonline.com/doi/10.1080/20961790.2022.2034715Forensic sciencescarotid bifurcationcarotid bodycarotid sinushaemorrhagehanging |
| spellingShingle | Julia Ulbricht Burkhard Madea Elke Doberentz Histological examination of carotid artery tissue in cases of ligature strangulation and hanging Forensic Sciences Research Forensic sciences carotid bifurcation carotid body carotid sinus haemorrhage hanging |
| title | Histological examination of carotid artery tissue in cases of ligature strangulation and hanging |
| title_full | Histological examination of carotid artery tissue in cases of ligature strangulation and hanging |
| title_fullStr | Histological examination of carotid artery tissue in cases of ligature strangulation and hanging |
| title_full_unstemmed | Histological examination of carotid artery tissue in cases of ligature strangulation and hanging |
| title_short | Histological examination of carotid artery tissue in cases of ligature strangulation and hanging |
| title_sort | histological examination of carotid artery tissue in cases of ligature strangulation and hanging |
| topic | Forensic sciences carotid bifurcation carotid body carotid sinus haemorrhage hanging |
| url | https://www.tandfonline.com/doi/10.1080/20961790.2022.2034715 |
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