Violent Crimes

Non-Fatal Strangulation

Non-fatal strangulation is the most lethal form of Intimate Partner Violence perpetrated against woman. The odds for homicide increase by 750% for victims who have been previously strangled, compared to victims who have never been strangled. 

The abuser is saying “I am warning you. I can kill you at any time.” 

1 in 4 women have experienced IPV.  

Of women at high risk, 68% have experienced near-fatal strangulation. 

97% of women are strangled manually 

38% of women have lost consciousness 

35% of women who have experienced non-fatal strangulation have also been sexually assaulted/abused. 

70% of women who have experienced non-fatal strangulation thought they were going to die. 

50% of the victims of fatal strangulation do not have visible injuries.  

There are 3 types of strangulation, all of which may cause unconsciousness or death. Unconsciousness or death occurs due to  

  • Blocking of the carotid artery: this prevents blood flow, thus oxygen, from reaching the brain 
  • Blocking of the jugular vein: this prevents the deoxygenated blood from exiting the brain 
  • The complete obstruction of the airway  

According to Dr Bill Smock of the Louisville Metro Police department, only 5kg’s of pressure need be applied to the carotid artery to cause acute death of the victim. 1.2kg’s – 2kg’s of pressure need be applied to the jugular vein in order to cause acute death, and 7.5kg’s – 30 kg’s of pressure need be applied to the vertebral arteries. 

Death may also result from Anoxic (deprivation of oxygen) or Hypoxic (reduced oxygen supply) brain cell death.  

Although death may not be an immediate consequence of strangulation, it may eventuate days, weeks or months later due to multi system organ failure, as well as Anoxic or Hypoxic brain cell death. Up till his point, a victim may present as healthy. 

Furthermore, a victim could suffer various forms of stroke dependent on the injuries sustained.  

Acute Thrombotic Stroke: this form of stroke is caused by a clot that has formed within the carotid artery. 

Acute Embolic Stroke: the plaque in the arteries can break off and travel to the brain. 

Delayed Cryptogenic Stroke: Cerebral infarcts (small localised area of dead tissue resulting from lack of blood supply). This can occur month to years of the injury has been sustained.  

Another form of injury identified by Dr Bill Smock is Carotid Artery Dissection. This occurs when there are tears within the artery resulting in death, stroke or long-term therapy. 

It is critical that a victim of strangulation, whether or not they have lost consciousness or have visible injuries, have an immediate medical assessment.  

Signs and Symptoms of Non-Fatal Strangulation


  • Memory loss 
  • Loss of consciousness 
  • Behavioral changes 
  • Loss of sensation 
  • Weakness of extremities 
  • Difficulty speaking 
  • Fainting 
  • Urination 
  • Defecation 
  • Vomiting 
  • Dizziness 
  • Headaches 

Head, Eyes and Ears

  • Petechiae 
  • Bloody red eyeballs  
  • Vision changes 
  • Droopy eyelids 
  • Bruising behind or bleeding from the ear 
  • Facial drooping or swelling 


  • Redness 
  • Scratch marks 
  • Fingernail impressions 
  • Bruising 
  • Swelling 
  • Ligature marks 

Voice Changes

  • Rasping or hoarse voice 
  • Inability to seak 
  • Clearing of throat 
  • Coughing 
  • Drooling 
  • Swelling to throat (this may result in delayed death) 


  • Difficulty breathing (swelling of the throat) 
  • Respiratory distress 
  • Inability to breath 

Those working with victims of IPV should be aware of  

  • Petechiae 
  • Red eyes 
  • Swelling to face or neck 
  • Swollen lips or tongue 
  • Difficulty breathing 
  • Difficulty speaking 
  • Redness, bruising or swelling to the neck 
  • Respiratory distress 

If any of these symptoms are apparent the victim should be advised to seek urgent medical advice. 

Do you require assistance from our Victim Support Unit in relation to this type of crime or similar?