Characterization of haemorrhages at the origin of the sternocleidomastoid muscles in hanging.

Haemorrhages at the periostal-clavicular origin of the sternocleidomastoid muscles were found in 52 out of 54 cases of death by hanging. This cervical haemorrhage is most frequently found in death by hanging, but only seldomly seen in other causes of death and can therefore be regarded as being typical for death by hanging. The frequency of this finding on the side of the highest point of the ligature mark is significantly higher, thereby supporting the hypothesis of extension as the causative mechanism. External cardiac massage and assisted breathing have no influence on the occurrence of haemorrhages. Histology shows the haemorrhages to be mainly directly epiperiostal, however, many cases displayed concurrent sub- and intraperiostal extravasations. Artificial post mortem production of these findings is discussed in the light of the literature.