Editing Strangling (section)

==General==
[[Image:Gray513.png|thumb|left|200 px|The neck contains several vulnerable targets for compression including the [[carotid arteries]].]]
Strangling involves one or several mechanisms that interfere with the normal flow of [[oxygen]] into the brain:<ref name=jones>{{cite web|author=Jones, Richard| website=forensicmed.co.uk|title=Asphyxia|url=http://www.forensicmed.co.uk/asphyxia.htm|archive-url=https://web.archive.org/web/20060226102952/http://www.forensicmed.co.uk/asphyxia.htm|url-status=dead|archive-date=26 February 2006|date=26 February 2006}}</ref><ref>{{cite web|author=Jones, Richard| website=forensicmed.co.uk|title= Strangulation|url=http://www.forensicmed.co.uk/strangulation.htm|archive-url=https://web.archive.org/web/20060430224427/http://www.forensicmed.co.uk/strangulation.htm|url-status=dead|archive-date=30 April 2006|access-date=30 April 2006}}</ref>
*Compression of the [[carotid arteries]] or [[jugular veins]]—causing [[cerebral ischemia]].
*Compression of the [[laryngopharynx]], [[larynx]], or [[Vertebrate trachea|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; [[cerebral ischemia|vascular obstruction]] is usually the main mechanism.<ref name=ferris>{{cite web |url=http://www.pathology.ubc.ca/path425/Others/MedicolegalInvestigationOfDeathAndForensic/AsphixiaDrJAJFerris.doc |title=Asphyxia |website=pathology.ubc.ca |author=J. A. J. Ferris |archive-url=https://web.archive.org/web/20090927122254/http://www.pathology.ubc.ca/path425/Others/MedicolegalInvestigationOfDeathAndForensic/AsphixiaDrJAJFerris.doc |archive-date=27 September 2009 |url-status=dead}}</ref> Complete obstruction of blood flow to the brain is associated with irreversible [[brain damage|neurological damage]] and [[death]],<ref name=koiwai2>Koiwai, Karl. [http://judoinfo.com/chokes5.htm How Safe is Choking in Judo?]. ''judoinfo.com''. URL last accessed 3 March 2006.</ref> but during strangulation there is still unimpeded blood flow in the [[vertebral arteries]].<ref name=reay>Reay, Donald; Eisele, John. [http://www.charlydmiller.com/LIB/1982neckholds.html Death from law enforcement neck holds]. ''charlydmiller.com''. URL last accessed 3 March 2006</ref> Estimates have been made that significant occlusion of the [[carotid arteries]] and [[jugular veins]] occurs with a pressure of around {{convert|3.4|N/cm2|abbr=on}}, while the [[Vertebrate trachea|trachea]] demands six times more at approximately {{convert|22|N/cm2|abbr=on}}.<ref name=gunther>Gunther, Wendy. [http://www.aikiweb.com/techniques/gunther1.html On Chokes (Medical)], with quotations from Spitz and Fisher's ''Medicolegal Investigation of Death: Guidelines for the Application of Pathology to Crime Investigation''. ''www.aikiweb.com''. URL last accessed 3 March 2006.</ref>

As in all cases of strangulation, the rapidity of death can be affected by the susceptibility to [[carotid sinus stimulation]].<ref name=ferris/>  [[carotid sinus#Carotid sinus reflex death|Carotid sinus reflex death]] is sometimes considered a mechanism of death in cases of strangulation, but it remains highly disputed.<ref name="jones"/><ref>Passig, K. [http://www.datenschlag.org/howto/atem/english/csr.html Carotid Sinus reflex death - a theory and its history] {{Webarchive|url=https://web.archive.org/web/20120504044744/http://datenschlag.org/howto/atem/english/csr.html |date=2012-05-04 }}. ''datenschlag.org''. URL last accessed 28 February 2006.</ref> The reported time from application to [[unconsciousness]] varies from 7-14 seconds if effectively applied <ref name=koiwai>Koiwai, Karl. [http://judoinfo.com/chokes6.htm Deaths Allegedly Caused by the Use of "Choke Holds" (Shime-Waza)]. ''judoinfo.com'' URL last accessed 3 March 2006.</ref> to one minute in other cases, with death occurring minutes after unconsciousness.<ref name=jones/>