Read it again, please. The first page summary states cause of death as asphyxiation from strangulation. Just above the ME's signature.
Well, that's not quite how I read it but maybe I'm not reading it right. It doesn't seem to make a determination of WHICH was THE cause, only that both were? Here's the quote:
"Cause of death of this six year old female is asphyxia by strangulation associated with craniocerebral trauma".
I see your point but the sentence doesn't seem definitive as to what THE cause was.
It reads to me like he's saying that BOTH were the cause without distinguishing precedence of one over the other.