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In cases of hanging death usually occurs immediately after strangulation and is caused by ischemic cerebral damage due to neck compression in some cases in combination with respiratory obstruction. We report on a case of delayed death 4 days after an attempted suicide by hanging where the individual was conscious and showed no neurological abnormalities. The cause of death was a cerebral infarction following a traumatic thrombosis of the subtotally ruptured carotid arteries.