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Acute alcohol intoxication and lethal neck flexion

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Abstract

Positional asphyxia occurs when the mechanics of normal respiratory processes are impaired by the position of the body, not by external crushing forces. It is a well-known complication of drug and alcohol intoxication. However, less well appreciated is the potential role of neck hyperflexion as a specific cause of death in individuals with acute alcohol intoxication. Two cases are reported to demonstrate the usefulness of meticulous scene descriptions and documentation in cases of alcohol toxicity. Case 1: An intoxicated 51-year-old woman was found deceased with neck hyperflexion due to pressure on her head from a vehicle bumper bar (blood alcohol 0.24%). Case 2: An intoxicated 46-year-old man was found lying on his back with his neck acutely flexed and his chin pressed firmly into his shoulder (blood alcohol 0.4%). In both cases the deaths were attributed to positional asphyxia due to hyperflexion of the neck associated with alcohol intoxication, with potential exacerbation from concussion and alcohol/drug effects. Careful review of the scene findings and statements from those who are first to find a body in cases of acute alcohol intoxication may be necessary to determine the incidence of marked neck hyperflexion and its possible role in these deaths.

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Correspondence to Roger W. Byard.

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Byard, R.W. Acute alcohol intoxication and lethal neck flexion. Forensic Sci Med Pathol 18, 223–225 (2022). https://doi.org/10.1007/s12024-021-00443-4

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