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Medical evidence assisting non-fatal strangulation prosecution: a scoping review
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  • Published on: 22 January 2024
    RE: Medico legal assisting non-fatal strangulation prosecution: a scoping review. BJM open 2023, 13: e 072077. DOI: 10.1136/bmjopen-2023-072077
    • Daniela Marchetti, medico-legal doctor Department of Health Care Surveillance and Bioethics, Section of Legal Medicine, Università Cattolica del S. Cuore, L. go F. Vi
    • Other Contributors:
      • Francesca Cittadini, medico-legal doctor

    To the Editor,
    We have read with great interest the review article entitled “Medico legal assisting non-fatal strangulation prosecution: a scoping review” by Sharman L.S et al. published in BJM open 2023, 13: e 072077.
    The detailed literature revision performed by the authors undoubtedly increased awareness about the risk of losing medico-legal evidence in cases of non-fatal strangulation (NFS), when cutaneous injuries are not visible or the few ones commonly not follow NFS as neck redness/bruising/haematoma; abrasions/petechiae also interesting eyes, gumline and the ears; subconjunctival haemorrhage.
    Therefore, all the medical evidence recorded by health professionals across the variety of healthcare settings, including emergency, general practice, and consultations in forensic context, is irreplaceable for the prosecution of NFS charges and for better healthcare for victims' survivors.
    This is especially true if one considers the possibility that the clinical presentation in cases of NFS could be limited to an oculo-sympathetic deficiency characterized by miosis and ipsilateral ptosis, better known as Claude Bernard syndrome (or Bernard-Horner syndrome). This ophthalmic sign is due to anatomic interruption/steering of the cervical sympathetic tracts of the autonomic nervous system at the level of the common carotid artery bifurcation and the angle of the jaw where the superior cervical ganglion is sited. However, very little attention in bett...

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    Conflict of Interest:
    None declared.