Mechanical asphyxia by hanging: A look back in search for evidence

The lack of pathognomonic findings to diagnose death by hanging is a well-known problem in forensic practice. This review examines the significance of signs that have been proposed over time as useful in forensic diagnosis, reporting the frequency of occurrence in the various published case histories. The analysis covered both internal and external signs, followed by an overview of potentially useful laboratory investigations. There is great variability in the frequency of occurrence of signs considered useful in forensic diagnosis. In addition, some of the signs that were considered historically valid must now be deemed not to be supported by sufficient scientific evidence as to their actual usefulness. There is a need for new case studies with overlapping methodologies and observed variables to enable effective and further comparisons.