Forensic Medicine
Investigation in Cases of Hanging

Investigation in Cases of Hanging

Hanging is the form of violent death produced by suspending the body with a ligature around the neck. The constriction force will be the weight of the body or a part of the body weight. In complete hanging, the weight of the complete body acts as the constriction force, and in partial hanging only a part of the bodyweight acts as the constriction force.

A pressure of 2 kg is sufficient to occlude the jugular venous system causing cerebral venous congestion. If the pressure is 5 kg, it can compress the carotid arteries, the trachea can be compressed with a constricting force of 15 kg. A force of 30 kg is sufficient to obstruct the vertebral arteries. This proves that complete suspension is not necessary, even partial hanging can cause the death of the person.

Hanging is classified into various types based on different factors. On the basis of knot position, it is classified into typical and atypical. Based on the degree of suspension – Complete and Partial hanging. On the basis of manner of death, they can be suicidal, homicidal, or accidental hanging. Other types include antemortem hanging, postmortem hanging, judicial hanging, autoerotic hanging, rescue hanging, and lynching.

The immediate causes of death are asphyxia due to obstruction of the airway, venous congestion due to obstruction of the jugular venous system, cerebral anemia due to compression of carotid arteries, fracture-dislocation of cervical vertebrae, vagal inhibition, and asphyxia and venous congestion combined. 

Death will occur immediately if the cervical vertebrae are fracture-dislocated or due to vagal inhibition. It takes about 3-5 minutes for death to occur in other causes like asphyxia and so on.

The delayed causes of death include aspiration pneumonia, infection and septicemia, pulmonary edema, hypoxic encephalopathy, laryngeal edema, and abscess of brain/encephalitis.

Symptoms of Death due to Hanging

  • The first symptoms are loss of power and subjective sensations.
  • Intense mental confusion, all power of logical thought is lost.
  • It is followed by loss of consciousness (within 15 seconds when a thin rope is used), Then follows a stage of convulsions.
  • The face is distorted and livid, eyes prominent, and there is violent struggling.
  • Respiration stops before the heart, which may continue to beat for about 10 to 15 minutes.
  • Even if a person survives in attempted hanging he will have secondary effects like amnesia, dementia, parotitis, cervical cellulite, epileptiform convulsions, hemiplegia. 

Examination in Cases of Hanging

  • Saliva might be seen on the clothes or can be seen dribbling from the mouth over the chin or chest.
  • The ligature material used for hangings leaves a ligature mark around the neck and it is the most significant sign of death from hanging. The ligature mark depends on the material, pattern, and texture of the ligature material. For eg:- A truck rope will leave an impression in the form of superficial abrasion. A narrow material will make a deep groove while a broad material is most likely to make superficial marks. If the ligature is passed twice around the neck, a double mark, one circular, and the other oblique may be seen. A heavier body will have a greater impression. If the noose tightens completely around the neck, the ligature mark will be seen completely encircling the neck. The longer the suspension, the deeper is the groove. The type of knot, position of the knot, and the slippage of the ligature material during suspension also affect the ligature mark.
  • The description of the ligature mark must include its direction, continuous or interrupted, color, depth and width, ligature pattern if any, the areas of the neck involved, and its relation to local landmarks. The ligature produces a furrow or a groove in the tissue which is pale in color, but it later becomes yellow-brown or dark-brown and hard like parchment, due to the drying of the slightly abraded skin.
  • The ligature mark is mostly seen above the thyroid cartilage and is running obliquely passing backward and upward on either side of the neck. If it is a fixed knot, the ligature mark usually looks like an inverted V with the apex of V corresponding with the site of the knot. In a slip knot, the noose may tighten around the neck thus producing marks over the neck except at the knots.
  • Ligature marks may not be visible or not prominent if the beard or the cloth intervenes between the ligature and skin. If the ligature is cut down within a short time and a soft broad ligature has been used.
  • If the hanging is from a low point of suspension, partial hanging when the body leans forward if ligature is winded twice or more than that around the neck, then the ligature mark may be horizontal to oblique.
  • The neck might appear to be stretched and elongated.
  • A line of congestion along the ligature mark may be seen. If the material used is a chain or grooved rope then the ligature mark will imprint the pattern of the ligature.
  • The friction between the skin and the rope can cause rope burns.
  • The brain may be congested due to the compression of the jugular venous system and might appear to be pale due to compression of carotid and vertebral arteries.
  • Typical hanging shows loss of face congestion and more of fractures while atypical hanging shows a high frequency of congestion of the face and low frequency of fracture of neck structure.
  • Lungs will be congested and edematous with Tardieu spots over the pleura. The abdominal viscera will also be congested.
  • Fracture of the hyoid bone is commonly seen in individuals above the age of 40.
  • The tissues underneath the marks will be dry, white, glistening with occasional ecchymoses in the adjacent muscles. Sometimes platysma and sternocleidomastoid may show contusions. 

Accidental Hanging

It is seen in children during play while imitating judicial hanging or in athletes who are in the habit of exhibiting hanging. Workmen falling from scaffolding may be hanged by becoming entangled in ropes.

Infants wearing restraining apparatus may wriggle partly out of it, and become asphyxiated by its tightening around their neck as they try to crawl away or fall over the side of the bed. The ligature need not completely encircle the neck to cause death. Some padding between the ligature and neck suggests an accident.

Homicidal Hanging

It is difficult for a single assailant to kill a person by hanging unless the victim becomes unconscious by injury or by a drug, or is taken unaware, or is a child or a very weak person.

Homicide should be suspected where there are signs of violence or disorder of furniture or other objects, where the clothing of the deceased is torn or disarranged, where there are injuries, either offensive or defensive.

If an individual is suspended upside down for a long time, death can occur in a few hours to a day either from acute cardiac or respiratory failure or a combination of both. Lynching is also considered homicidal hanging. Most of the time a planned homicidal hangings ends up as postmortem hanging.

A ligature applied to the neck within two hours of death will produce a ligature mark. Look for signs of dragging to the place of suspension. When a dead body/unconscious body is suspended, the rope is usually tied first around the neck, and then around the beam, branch of a tree, etc. The beam shows evidence of the rope having moved from below upwards as the body has been pulled up. Fibers from the rope cannot be found in the hands of the victim.

Suicidal Hanging

It is done by attaching a rope or any ligature material to a high point, such as a beam, ceiling fan, etc, and the lower end is formed into either a fixed loop or a slip-knot which is placed around the neck.

It is important to examine the point of attachment and the surrounding area. If the point is high, then it is likely that there will be a recent disturbance of dust caused while attaching the ligature. The deceased’s hands and sometimes part of his clothing may also show the presence of corresponding dust marks.

There may also be the disturbance of dust from the attached cord or from an abraded area particularly if a beam has been used to attach the ligature. In true suicidal hanging, the rope moves from above downwards.

Further, fibers from the rope may be found on the hands of the victim in suicidal hanging. The position of the ligature regarding the knot and how it is attached to the support must be compatible with self-suspension.

Superficial abrasions and sometimes small contusions overlying bony prominences of the limbs and trunk may be found in suicidal hangings due to contact of the body against nearby objects during voluntary or early involuntary movement.

Difference Between Antemortem and Postmortem Hanging

FeaturesAntemortem Postmortem
Ligature markPresence of imprint mark, Maybe grooved, brownish, parchment-likeNo such features
Salivary dribblePresentAbsent
Le Facie SympathiqueRarely presentAbsent
Asphyxia signsPresentAbsent
Drag marks over the bodyAbsentMaybe present


Cases of suicide by hanging are most common and frequently encountered. During a forensic investigation, it is necessary to determine the manner of hanging, whether it was suicidal, homicidal, accidental, postmortem, or antemortem hanging.

It may be confused with strangulation. Thus, it is important to know about the findings in death due to hanging and how to differentiate between suicidal or homicidal hanging and strangulation. 

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