Manual Strangulation
Definition
Compression of the neck by one or both hands. The most common type in intimate-partner violence. Creates asymmetric, fingertip-sized contusions and may leave no marks at all.
- Mechanism
- Neck compression by one or both hands
- Common context
- Intimate-partner violence
- Typical marks
- Asymmetric, fingertip-sized contusions
- Caveat
- May leave no external marks at all
Common questions
Why is the absence of visible neck marks not evidence that manual strangulation did not occur?+
Light or brief compression, application over clothing, or a delay between the assault and examination can all leave no visible bruising even when internal injury such as hyoid fracture or petechiae is present, so a clean external exam does not rule out strangulation.
How does the pattern of bruising help distinguish manual strangulation from other neck compression?+
Fingertip-sized, asymmetric contusions with a gap consistent with a thumb-and-fingers grip point to hands rather than a ligature, which instead tends to leave a continuous horizontal band; examiners map the bruise pattern against hand anatomy to support the distinction.
Related terms
- Carotid Artery Dissection
- A tear in the inner wall of the carotid artery caused by stretching or compression during strangulation. Can produce stroke hours to...
- Ligature Strangulation
- Compression by a cord, belt, wire, or similar item looped around the neck. The ligature mark shows the width and pattern of...
- Petechiae
- Pinpoint haemorrhages above the level of venous compression. They develop when venous outflow is blocked while arterial inflow continues, raising capillary pressure...
- Positional (Postural) Strangulation
- Compression of the neck caused by the weight of the body or an external object constraining the airway or neck vessels without...
- Strangulation Documentation Form
- A structured clinical tool, developed originally by the Training Institute on Strangulation Prevention, that systematically prompts recording of mechanism, symptoms, and physical...