page_title: Strangling
section_title: General
hierarchical_section_title: Strangling / General
caption_attribution_description: English: The internal carotid and vertebral arteries. Right side. Deutsch: Rechte Arteria carotis
context_page_description: Strangling is compression of the neck that may lead to unconsciousness or death by causing an increasingly hypoxic state in the brain. Fatal strangling typically occurs in cases of violence, accidents, and is one of two main ways that hanging causes death.
  Strangling does not have to be fatal; limited or interrupted strangling is practised in erotic asphyxia, in the choking game, and is an important technique in many combat sports and self-defense systems.
  Strangling can be divided into three general types according to the mechanism used:
  Hanging—Suspension from a cord wound around the neck
  Ligature strangulation—Strangulation without suspension using some form of cord-like object called a garrote
  Manual strangulation—Strangulation using the fingers or other extremity
context_section_description: Strangling involves one or several mechanisms that interfere with the normal flow of oxygen into the brain:
  Compression of the carotid arteries or jugular veins—causing cerebral ischemia.
  Compression of the laryngopharynx, larynx, or trachea—causing asphyxia.
  Stimulation of the carotid sinus reflex—causing bradycardia, hypotension, or both.
  Depending on the particular method of strangulation, one or several of these typically occur in combination; vascular obstruction is usually the main mechanism. Complete obstruction of blood flow to the brain is associated with irreversible neurological damage and death, but during strangulation there is still unimpeded blood flow in the vertebral arteries. Estimates have been made that significant occlusion of the carotid arteries and jugular veins occurs with a pressure of around 3.4 N/cm² (4.9 psi), while the trachea demands six times more at approximately 22 N/cm² (32 psi).
  As in all cases of strangulation, the rapidity of death can be affected by the susceptibility to carotid sinus stimulation.  Carotid sinus reflex death is sometimes considered a mechanism of death in cases of strangulation, but it remains highly disputed. The reported time from application to unconsciousness varies from 7–14 seconds if effectively applied  to one minute in other cases, with death occurring minutes after unconsciousness.
caption: The neck contains several vulnerable targets for compression including the carotid arteries.
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