Which of the following is a sign of strangulation?

A change of voice is indicative of strangulation due to the pressure applied to the neck, which can affect the larynx and vocal cords. When the airway is compromised, alterations can occur in vocal production, manifesting as hoarseness, difficulty speaking, or a complete inability to produce sound. These symptoms arise as the neck structures become constricted, leading to swelling or changes in the tension of the vocal cords. This physiological response to strangulation signals the distress within the body and the urgency of the situation.

While dizziness, excessive sweating, and fluid retention can arise from various medical conditions, they are not specific indicators of strangulation. Dizziness might be attributed to multiple factors, including a lack of oxygen or blood flow, but it is not a direct sign of this type of injury. Excessive sweating can occur due to stress or other physiological responses unrelated to strangulation. Fluid retention might suggest systemic issues but lacks a direct correlation to the acute circumstances of strangulation as effectively as a change in voice does.