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Aug 18, 2024
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Death from hanging is attributable to an asphyxial factor, a circulatory factor and a neuro-vegetative factor.

Asphyxiation factor: the strap, generally placed in the thyrohyoid space, moves the hyoid bone and the base of the tongue backwards and upwards which, by pressing against the palate and pharynx, causes occlusion of the airways. Only if the asphyxial factor intervenes can terminal asphyxial convulsions occur.

Circulatory factor: the interruption of the blood circulation at the level of the carotid arteries located on the sides of the neck (3.5 kg) and possibly of the vertebral arteries (16.6 kg) produces cerebral ischemia with immediate loss of consciousness. The closure of the jugular arteries instead causes acute venous stasis in the cephalic territory which produces edema.

Neurovegetative factor: intense stimulation of the vagus nerve, which runs vertically in the vasculonervous bundle of the neck together with the carotid artery anteriorly and the jugular vein posteriorly, and of the carotid-sinus receptors can produce immediate arrest of the heart with death from inhibition reflected.


Again from a medical-legal point of view, two types of hanging are recognized depending on the position of the noose: a typical hanging, if the knot corresponds to the back of the neck, and an atypical hanging, if the knot is located in a lateral or anterior position of the neck. Atypical hanging is one of those carried out with the aim of committing suicide,
 
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