Asphyxial Deaths and Petechiae: A Review

    Volume 45, Issue 6 (November 2000)

    ISSN: 0022-1198

    CODEN: JFSOAD

    Page Count: 4


    Hirsch, CS
    Office of Chief Medical Examiner of the City of New York, New York University School of Medicine, New York, NY

    Ely, SF
    Office of Chief Medical Examiner of the City of New York, New York University School of Medicine, New York, NY

    (Received 11 October 1999; accepted 21 December 1999)

    Abstract

    Conjunctival and facial petechiae, although nonspecific findings, are considered hallmarks of asphyxial deaths. Consensus in the literature suggests that their pathogenesis is related to the combined effects of increased cephalic venous pressure and hypoxic damage to endothelial cells. Despite the common knowledge that they are neither predictable findings in all asphyxial deaths nor rare in natural, nonaphyxial deaths, the belief persists that petechiae are corroborative evidence of asphyxia. We suggest that a clear, physiologically based understanding of the pathogenesis of petechiae of the head is critical for their appropriate interpretation. We present a review of the literature and the basis of our conclusion that conjunctival and facial petechiae are the product of purely mechanical vascular phenomena, unrelated to asphyxia or hypoxia.


    Paper ID: JFS14878J

    DOI: 10.1520/JFS14878J

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    Author
    Title Asphyxial Deaths and Petechiae: A Review
    Symposium , 0000-00-00
    Committee E30