Forensic Pathology Service, Catalonian Institute of Legal Medicine and Forensic Science (IMLCFC), Ciutat de la Justícia, Gran Via de les Corts Catalanes, 111 Edifici G, 08075, Barcelona, Spain.
Departamento de Barcelona, Instituto Nacional de Toxicología y Ciencias Forenses (INTyCF), Ministerio de Justicia, Barcelona, Spain.
Int J Legal Med. 2022 Sep;136(5):1359-1362. doi: 10.1007/s00414-022-02832-y. Epub 2022 May 27.
Hanging is one of the most common methods of attempting suicide with a fast occurring death and a high lethality rate. Depending on how fast the hanged individuals are found, they may be rescued, which is referred to as "near-hanging." Whilst hypoxic and ischemic brain damage are common findings in hanging, intracranial hemorrhages seem to be a rare occurrence. To the authors' knowledge, this is the first autopsy case report of an intracerebral and subarachnoid hemorrhage in a delayed death after incomplete hanging. We hypothesize that the combination of two mechanisms is involved in the development of such hemorrhages. First, the persistent venous hypertension during incomplete hanging causing endothelial damage resulting in vascular leakage. Second, the reperfusion of the brain due to recovery of venous blood return after the release form the rope. Whereas intracranial hemorrhage is not a common finding in daily autopsy cases of fatal hanging, it might be a severe complication in rescued cases.
绞刑是最常见的自杀方式之一，其死亡过程迅速，致死率高。根据发现被绞死者的速度，他们可能会被抢救，这被称为“近乎绞刑”。虽然在绞刑中常见缺氧和缺血性脑损伤，但颅内出血似乎很少见。据作者所知，这是首例不完全绞刑后延迟死亡的颅内和蛛网膜下腔出血的尸检病例报告。我们假设两种机制的结合参与了此类出血的发生。首先，不完全绞刑时持续的静脉高压导致内皮损伤，从而导致血管渗漏。其次，由于绳索松开后静脉血回流恢复，大脑再灌注。虽然颅内出血在日常致命绞刑尸检病例中并不常见，但它可能是抢救病例中的严重并发症。
