Strangulation occurs when external pressure is applied to the neck, often by hands or a ligature, intentionally obstructing blood vessels or air passages. This restricts oxygen supply to the brain. It differs from “choking,” which happens when an internal object, like food, blocks the airway. Strangulation is a serious act of violence with severe, potentially delayed consequences.
Immediate Bodily Responses
Direct neck compression during strangulation rapidly affects physiological functions. Pressure on the carotid arteries restricts oxygen-rich blood flow to the brain. At the same time, compression of the jugular veins prevents deoxygenated blood from draining, increasing pressure within the skull. This quickly deprives the brain of oxygen.
The trachea can also be compressed, directly impeding breathing and airflow. While blood flow restriction alone can cause unconsciousness, tracheal compression can also lead to asphyxia. Unconsciousness can occur rapidly, sometimes within seconds, from relatively little pressure on the carotid arteries or jugular veins.
Beyond oxygen deprivation, pressure on the neck can affect heart rate and blood pressure, potentially leading to cardiac arrest. Loss of consciousness can occur quickly, sometimes within seconds, often followed by involuntary urination or defecation as muscle tone is lost.
Visible signs of strangulation may appear on the face and neck due to disrupted blood flow. These include petechiae, small red or purple spots, and facial swelling, bruising, or scratch marks. Ligature marks may be present if an object was used. Internally, victims may experience voice changes, such as hoarseness, and difficulty swallowing due to laryngeal injury or swelling.
Potential Health Complications
Strangulation can lead to serious and delayed medical complications, sometimes appearing hours, days, or even weeks later. One severe risk is vascular injury, particularly to the carotid arteries. Compression can cause tears in the arterial walls, known as carotid artery dissection, which may lead to the formation of blood clots. These clots can subsequently dislodge and travel to the brain, causing an ischemic stroke. Such strokes can occur days or even months after the initial incident.
Damage to the airway and larynx is another concern. Swelling of the soft tissues in the throat can develop hours after the event, potentially leading to delayed airway obstruction and breathing difficulties. Fractures of the laryngeal cartilages or the hyoid bone can result from manual strangulation. These injuries can cause persistent voice changes, hoarseness, vocal cord paralysis, and chronic difficulty swallowing.
Brain injury due to oxygen deprivation is a long-term consequence. Hypoxic or anoxic brain injury can result in cognitive impairments, including memory problems, difficulty concentrating, and issues with executive function. Seizures are also a possible neurological outcome. While less common, severe force or movement of the neck during strangulation could potentially lead to spinal cord injuries. Seeking medical evaluation immediately after any strangulation incident, even without obvious external injuries, is important.
Psychological and Emotional Aftermath
Beyond the physical injuries, being subjected to strangulation leaves significant psychological and emotional impacts. The experience often induces an intense fear of death. This can lead to the development of acute stress disorder and post-traumatic stress disorder (PTSD). Symptoms of PTSD include flashbacks, severe anxiety, and intrusive thoughts about the event.
Emotional distress commonly manifests as fear, helplessness, and vulnerability. Individuals may experience depression, generalized anxiety, and panic attacks. There can also be difficulties trusting others and a heightened sense of anger.
Behavioral changes often accompany the psychological trauma. Sleep disturbances, including insomnia and nightmares, are common. Victims may exhibit avoidance behaviors, such as shying away from social situations or places that remind them of the incident. Hypervigilance, an exaggerated state of alertness, can also develop. Seeking mental health support is a step in navigating these emotional challenges.
Legal Aspects and Reporting
Non-fatal strangulation is recognized as a serious criminal offense. It is often classified as a felony, or as a specific strangulation offense. Laws have been enacted to criminalize non-fatal strangulation, acknowledging it as a distinct act of violence.
Reporting strangulation to law enforcement is important. The transient nature of strangulation injuries, which often leave no visible marks or only subtle ones, underscores the importance of immediate documentation. Medical evaluation plays a role in evidence collection, as healthcare professionals can identify and document internal injuries or subtle physical signs.
Victims of strangulation have access to various support services. These resources include domestic violence hotlines, victim advocacy groups, and legal aid. Organizations assist survivors in understanding their rights and navigating the legal system.