Vehicle-assisted ligature strangulation: case report of a bizarre suicide method and literature review

Introduction. Vehicle-assisted ligature strangulation is an extremely rare suicide method. We report a case of a 43-year-old man who attached one end of a nylon rope to a tree, fastened the other end around his neck and started his vehicle, leading to an incomplete decapitation. The rope was not found during crime scene investigation; hence policemen wrongly assumed it was a homicide. Materials and methods. We performed a literature review of all the studies published on the major scientific search engines: only 14 cases of this unusual suicide method are described in literature and only one of which involved an incomplete decapitation. We analysed all available cases regarding victim’s gender, possible decapitation, rope features (material, length, thickness) and its eventual breaking. Results. 93,3% of victims were male. Complete decapitation occurred in 6 cases, incomplete decapitation in 2 cases, decapitation was absent in 7 cases. Length and thickness of the ropes were extremely variable. The materials included metal, nylon, and hemp. In both cases of partial decapitation, and in 4 out of 7 cases in which decapitation was not described, the rope was broken. Considering the cases in which complete decapitation occurred, none of the ropes broke. Conclusions. Vehicle-assisted ligature strangulation is almost exclusively chosen by men, careful on-site inspection should be performed, to rule out other manners of death; rope features should be noted to compare them to the ligature mark and the possible decapitation since longer and more resistant ropes are more commonly associated to complete decapitation.