The most common signs of strangulation are marks or bruises on the neck, petechiae (small red or purple spots) on the face and eyes, trouble breathing, and impaired voice. Additionally, someone who has been strangled may experience dizziness, confusion, and loss of consciousness. More serious signs include hemorrhaging in the eyes, swelling in the extremities, and changes in skin color. In cases of asphyxiation, the victim may show signs of cyanosis (blue lips or fingertips). Furthermore, a person who has been strangled may have a swollen and bruised tongue, as well as abrasions or lacerations in the mouth or throat. It is important to note that strangulation can be fatal, and if someone has died of strangulation, a post-mortem examination should be done to determine the cause of death.