Indian Journal of Forensic Medicine & Toxicology

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The Assessment of the Location of Carotid Bifurcation


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1 The Department of Legal Medicine, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
     

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We experienced suicidal hanging cases without a ligature in front of neck and a manual strangulation without facial congestion. In the last case Carotid bifurcation (CB) located between C2-3 and at the upper of muscular bleeding. Carotid sinus stimulation is thought as a cause of syncope. Carotid sinus reflex is attributed to the stimulation, but somebody did not respond to the procedure. We showed the anatomical variation of CB location. Measurements were performed on 100 cadavers by the direct inspection method. CB level was compared to the level of cervical vertebra. Most frequency of CB was found at the level of C3. CB was variously distributed from the intermediate position of C1-2 to lower border of C5 on the vertebral column in Japanese population. The distribution pattern may be different from other population. 54% of the level of CB was asymmetrical between the right and left side. Our findings support the presumption that suicidal hanging and manual strangulation death due to carotid bifurcation stimulation cannot provoke death alone.

Keywords

Carotid Sinus Reflex, Carotid Artery Bifurcation, Autopsy
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  • Puschel K, Turk E, Lach H. Asphyxia-related deaths. Forensic Sci Int 2004; 144: 211-214.

  • Ikeda N, Harada A, Suzuki T. The course of respiration and circulation in death due to typical hanging. Int J Leg Med 1992; 104: 313-315.

  • Kerr SRJ, Pearce MS, Brayne C, Davis RJ, Kenny RA. Carotid sinus hypersensitivity in asymptomatic older persons: implications for diagnosis of syncope and falls. Arch Intern Med 2006; 166: 515-520.

  • Brignole M, Menozzi C, Gianfranchi L, Oddone D, Lolli G, Bertulla A. Carotid sinus massage, eyeball compression, and head-up tilt test in patients with syncope of uncertain origin and in healthy control subjects. Am Heart J 1991; 122(6): 1644-1651.

  • Goldlist B, Naglie G. Carotid sinus syndrome in the elderly. Am J Med 1995; 98(1): 100-101.

  • Coplan NL. Carotid sinus hypersensitivity and syncope cause/effect or true/unrelated. Arch Intern Med 2006; 166(5): 491-492.

  • B. Schrag P, Mangin P, Vaucher MD. Death caused by cardioinhibitory reflex; what experts believe. Am J Forensic Med Pathol. 31, in press.

  • T Lewis. Vasovagal syncope and the carotid sinus mechanism. BMJ 1932;1: 873-876.

  • HE Hering. Die Sinusreflexe vom Sinus caroticus warden durch einen Nerven vermittelt, de rein Ast des Nervus glossopharyngeus ist, Munch Med Wschr 1924; 71: 1265-1266.

  • P Schweitzer, LE Teichholz. Carotid sinus massage. Its diagnostic and therapeutic value in arrhythmias. Am J Med 1985; 78(4): 645-654.

  • DS Hess, T Hanlon, M Scheinman, R Budge, J Desai. Termination of ventricular tachycardia by carotid sinus massage. Circulation 1982; 65(3): 627-633.

  • R Rossen, H Kabat, JP Anderson. Acute arrest of cerebral circulation in man. Arch Neurol Psychiatry 1943; 50: 510-528.

  • Vitek JJ, Reaves P. Thoracic bifurcation of the common carotid artery. Neuroradiology 1973; 5: 133-139.

  • Roberts LK, Gerald B. Absence of both common carotid arteries. AJR 1978; 130: 981-982.

  • Ribeiro RA, Ribeiro JA, Rodrigues OA, Caetano GA. Common carotid artery bifurcation level related to clinical relevant anatomical landmarks. Int. J. Morphol. 2006; 24(3): 413-416.


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  • The Assessment of the Location of Carotid Bifurcation

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Authors

Satoshi Furukawa
The Department of Legal Medicine, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
Lisa Wingenfeld
The Department of Legal Medicine, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
Ikuo Sakaguchi
The Department of Legal Medicine, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
Tokiko Nakagawa
The Department of Legal Medicine, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
Akari Takaya
The Department of Legal Medicine, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
Satomu Morita
The Department of Legal Medicine, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
Shigeru Yamasaki
The Department of Legal Medicine, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan
Katsuji Nishi
The Department of Legal Medicine, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan

Abstract


We experienced suicidal hanging cases without a ligature in front of neck and a manual strangulation without facial congestion. In the last case Carotid bifurcation (CB) located between C2-3 and at the upper of muscular bleeding. Carotid sinus stimulation is thought as a cause of syncope. Carotid sinus reflex is attributed to the stimulation, but somebody did not respond to the procedure. We showed the anatomical variation of CB location. Measurements were performed on 100 cadavers by the direct inspection method. CB level was compared to the level of cervical vertebra. Most frequency of CB was found at the level of C3. CB was variously distributed from the intermediate position of C1-2 to lower border of C5 on the vertebral column in Japanese population. The distribution pattern may be different from other population. 54% of the level of CB was asymmetrical between the right and left side. Our findings support the presumption that suicidal hanging and manual strangulation death due to carotid bifurcation stimulation cannot provoke death alone.

Keywords


Carotid Sinus Reflex, Carotid Artery Bifurcation, Autopsy

References