Suicidal vehicle-assisted ligature strangulation resulting in complete decapitation: an autopsy report and a review of the literature.

The victim (59-year-old male) used a long hemp rope tied between his neck and a cherry tree while attempting to drive his car away, resulting in complete decapitation. At autopsy, the decapitation wound of the head and the torso corresponded perfectly; a clear-cut severance plane was found at the bottom of the skull. In contrast to suicidal decapitation by hanging and traumatic railway injury, autopsy findings for vehicle-assisted ligature strangulation are rarely reported. A review of the literature concerning suicidal vehicle-assisted ligature strangulation suggested a striking young or adult male predominance, and the wound margins were usually clear-cut with a sharply-demarcated encircling abrasion zone. The present case presented some notable autopsy findings involving wound morphology and pathological changes in organs related to the mechanisms of injury and death. Despite complete decapitation, the face was congestive, the lungs were congested with findings of acute respiratory distress, and the brain was markedly swollen with diffuse and severe astrocyte injury, suggesting that asphyxiation was involved in the death before decapitation.