Significant external pressure applied to the neck results in strangulation. This is caused by hanging, ligature strangulation, manual strangulation, and postural strangulation. Circumstances surrounding strangulation injuries include homicides or assaults, suicides, accidents, and judicial executions. Depending on the method used, death from strangulation may occur by one of three mechanisms: injury to the spinal cord and brain stem; mechanical constriction of the neck structures; and cardiac arrest.23 These are explained below.

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