JUDICIAL HANGING - POSTMORTEM RADIOGRAPHIC, CT, AND MR-IMAGING FEATURES WITH AUTOPSY CONFIRMATION

PURPOSE: To assess postmortem radiologic and pathologic findings by us ing modern imaging and autopsy techniques in two recent cases of judic ial hangings. MATERIALS AND METHODS: Cervical spine radiography; compu ted tomography (CT) of the head, neck, and chest; magnetic resonance ( MR) imaging of the head and cervical spine; and vertebral angiography were followed by a complete autopsy, including head and neck dissectio n. RESULTS: The first case (subaural knot) showed cervical spine ligam entous injury and partial disruption of the vertebral arteries without vertebral subluxation or injury to the cervical cord. The second ease (submental knot) showed complete ligamentous disruption and subluxati on at C2-3 with complete cord transection. In both eases, minimally di splaced transverse process fractures were present, and CT and MR imagi ng of the head showed diffuse subarachnoid hemorrhage. CONCLUSIONS: Th e extent and distribution of injuries differed markedly in the two cas es. The first case involved loss of consciousness probably from subara chnoid hemorrhage or cerebral hypoxia, followed by death due to cerebr al anoxia. The second ease involved a major spinal cord injury with su barachnoid hemorrhage.