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Author(s)YearTitleSummaryGlass, Laughon,Campbell, Block,Hanson, Sharps,Taliaferro2007
Non-fatal strangulation isan important risk factor for homicide of women
Underscores need for strangulation screening in clinicalsetting because non-fatal strangulation is a significant risk factor for attempted or completed homicides.Non-fatal strangulation was reported in 10% of abusedcontrols, 45% of attempted homicides, and 43% of homicides.Prior non-fatal strangulation was associated with greater than 6-fold odds of becoming an attempted homicide and 7-fold odds of becoming a completed homicide.The mean age of women who have been abused andstrangled is 27.07 yrs vs. 30.4 yrs for abused and not-strangled women (* Stat. Significant)Non-fatal strangulation was more common for AfricanAmerican women vs. other groups (40% African American,17% white, 22% Latina)Strack, McClane,Hawley2001
A review of 300 attemptedstrangulation cases part I:Criminal Legal Issues
85% - 90% of cases are handled as misdemeanor cases (SanDiego) - Max. sentence of 1 year and max fine of $10,000Decision to prosecute depends on a variety of factors: levelof violence, injury, statements from the victim, witness or suspect, corroborating evidence (photographs, witnesses,911 tapes, medical records), and criminal history99% were female.67% involved female to male violencesuspect was: male husband (25%), cohabiting partner 
 
(37%), co-parent (26%), former partner (6%), current boyfriend (6%)average length of relationship: 4.3 yearsmechanism: 97% manual and 3% ligatureManual: "one hand, two hands, arm, or choke-hold"Children were present in 41% of cases (author believes thisis an underestimation)50% : no visible injuries35% : "injuries to minor to photograph"15% : "Injury sufficient to photo"Symptomatology: 18% pain only, 1% voice changes, 5% breathing changes, 2% problems swallowing, 67% nosymptom documented or reportedIn 89% of cases there was a history of domestic violence5% of victims sought medical attention within 48 hours;descriptions from medical professionals aided prosecutors because of their specific and detailed naturePolice neglected to document key pieces of informationMcClane, Strack,Hawley2001
A review of 300 attemptedstrangulation cases part II:Clinical Evaluation of theSurviving Victim
Often, victims of strangulation are treated as unreliable patients because of how they present in the ED.Victims of strangulation presenting with subconjunctivalhemorrhages may have this injury mistaken for pink-eyeArticle cites other oversights possible in the EDHawley,McClane, Strack 2001
A review of 300 attemptedstrangulation cases Part III
Purpose: to review injuries recognizable at autopsy in casesof strangulation in cases of IPV and the instances that
 
- Injuries in Fatal cases
 jeopardize the collection of evidenceEven in fatal cases, there may not be external evidence of abuse. Result – evidence disturbedInjuries change over time (importance – duration of time between abuse and presentation)Contusion on top or back of shoulder – indicative of “sleeper hold”Finger nail marks on head, face, neck – often victim’s ownas she attempts to pry attacker’s grip looseLigature abrasions horizontal across neck Medical resuscitation obscures evidence of abuseSmith, Mills,Taliaferro2001
Frequency and relationshipof reportedsymptomatology in victimsof IPV: The effect of multiple strangulationattacks
Victims of multiple strangulation report an increasedfrequency of neck and throat injuries, neurologic disorders,and psychological disordersManual Strangulation - 'throttling' - compression of the neck with one or two hands; may restrict blood flow andoxygenationIncrease in Neck and Throat injuries - (only significant for 5+): scratches, red linear marks, sore throat, pain, voicechanges; (significant for 2-5): voice changesIncrease in Neurologic syptoms - (5 +): dizziness, tinnitis,weakness, muscle spasms; (2-5): memory loss, tinnitisIncrease in Psychological symptoms (significance rare because often control was 50%+): (5+): Nightmares
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