An assessment of head and neck injury prevalence and patterns resulting from fatal interpersonal strangulation cases in Australia

Forensic Sci Int. 2026 Jul 28;388:113081. doi: 10.1016/j.forsciint.2026.113081. Online ahead of print.

ABSTRACT

Strangulation is a form of violence that involves the application of blunt force to the neck to control, coerce, or incapacitate. Most strangulation detection occurs within the soft tissues of the head and neck; however, robust osteological understanding is essential to ascertain the involvement of strangulation in those who are alternatively preserved, decomposed, or skeletonized, where soft tissue findings are unavailable or unreliable. The study analyzed head and neck injuries from 120 cases of fatal interpersonal strangulation recorded within the National Coronial Information System (NCIS) Database in Australia. The study aimed to augment our current understanding of head and neck injury patterns resulting from fatal interpersonal strangulation and provide a formalized Australian perspective on the phenomenon of interpersonal strangulation. Injuries were documented in almost all areas of the head and neck, with the most common injuries occurring in soft tissue structures such as muscle and skin. Some variables, such as sex, alcohol use, age, and BMI, were found to be statistically significantly associated with the odds of injury in specific anatomical regions, including cutaneous injuries of the neck, neck musculature injuries, intraoral space injuries, and laryngeal cartilaginous skeleton fractures. The findings contribute to our current understanding of strangulation in Australia, encompassing pathological, odontological, and anthropological perspectives, and provide exploratory statistical analysis and descriptive epidemiology of injury patterns relevant to medico-legal investigation.

PMID:42546551 | DOI:10.1016/j.forsciint.2026.113081