Asphyxia in medicine includes pathophysiological processes and conditions resulting from various causes that lead to disturbance of respiratory function. Signs of asphyxia are punctiform bleeding, cyanosis, oedema, fluid blood, enlargement of the right heart. Inhalation of blood represents asphyxic mechanism of death, which (as in drowning or hanging, suffocation or strangulation) takes on average between 3-5 minutes.Craniocerebral injuries are those injuries that occur through direct or indirect force, causing a disruption of the morphological and physiological integrity of the soft tissue and skeletal system of the head and / or brain.Given the clinical picture we can distinguish open and closed craniocerebral injury. Due to the integrity of the dura mater we have penetrating and nonpenetrating injury. We have concussion, contusion of the brain, compression of the brain and fractures of the skull.In a retrospective 38 year study we have obtained interesting results related to the manner of death, alcohol intoxication and distribution of injuries.For all cases there is a common conclusion, regarding the summary of medical examiners and court experts, proffesional emergency and medical assistance would probably save the life, if the injured person was timely laid on its side or stomach, which would prevent the possibility of blood aspiration.