A petechial hemorrhage is a tiny pinpoint red mark that is an important
sign of asphyxia caused by some external means of obstructing the
airways. They are sometimes also called petechiae. Their presence often
indicates a death by manual strangulation, hanging, or smothering. The
hemorrhages occur when blood leaks from the tiny capillaries in the
eyes, which can rupture due to increased pressure on the veins in the
head when the airways are obstructed. If petechial hemorrhages and
facial congestion are present, it is a strong indication of asphyxia by
strangulation as the cause of death.
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