Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-23T04:00:29.740Z Has data issue: false hasContentIssue false

Sexual asphyxia causing blunt carotid artery injury and Horner's syndrome

Published online by Cambridge University Press:  25 September 2012

A Muddaiah
Affiliation:
ENT Department, St Helens and Knowsley NHS Trust, St Helens, UK
A Banigo*
Affiliation:
ENT Department, St Helens and Knowsley NHS Trust, St Helens, UK
F Galli
Affiliation:
ENT Department, St Helens and Knowsley NHS Trust, St Helens, UK
M A Latif
Affiliation:
ENT Department, Kettering General Hospital, UK
*
Address for correspondence: Mr A Banigo, Senior House Officer, ENT Department, St Helens and Knowsley NHS Trust, St Helens L35 5DR, UK Fax: +44 (0)1744 646 331 E-mail: [email protected]

Abstract

Objective:

To highlight a rare cause of Horner's syndrome, and to review the management of blunt carotid artery injury.

Method:

Literature search via PubMed for related articles.

Results:

Horner's syndrome and blunt carotid artery injury are rare phenomena; sexual asphyxia as a cause has not previously been reported. This case is also the first of its kind to have radiological evidence of injury to the external carotid artery but not the internal carotid artery. In Horner's syndrome, additional symptoms of ipsilateral headache or neck pain, tinnitus, or any cerebral ischaemic symptoms should raise suspicion of blunt carotid injury.

Conclusion:

Blunt carotid artery injury is a potentially fatal condition and can present without radiological evidence. Early recognition and management with anticoagulants or antiplatelet drugs is crucial to prevent mortality and morbidity.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Costello, D, Salmon, J, Milford, C, Pretorius, P. A rare cause of Horner syndrome. J Laryngol Otol 2010;124:925–7CrossRefGoogle ScholarPubMed
2Starr, BE, Shubert, A, Baumann, B. A child with isolated Horner's syndrome after blunt neck trauma. J Emerg Med 2004;26:425–7CrossRefGoogle ScholarPubMed
3Chan, CC, Paine, M, O'Day, J. Carotid dissection: a common cause of Horner's syndrome. Clin Experiment Ophthalmol 2001;29:411–15CrossRefGoogle ScholarPubMed
4Fabian, TC, Patton, JH, Croce, MA, Minard, G, Kudsk, KA, Pritchard, EF. Blunt carotid injury: importance of early diagnosis and anticoagulant therapy. Ann Surg 1996;223:513–25CrossRefGoogle ScholarPubMed
5Shievink, WI, Atkinson, JLD, Bartleson, JD, Whisnant, JP. Traumatic internal carotid artery dissections caused by blunt softball injuries. Am J Emerg Med 1998;16:179–82CrossRefGoogle Scholar
6Cogbill, TH, Moore, EE, Meissner, M, Fischer, RP, Hoyt, DB, Morris, JA et al. The spectrum of blunt injury to the carotid artery: a multicenter perspective. J Trauma 1994;37:473–9CrossRefGoogle Scholar
7Miller, PR, Fabian, TC, Bee, TK, Timmons, S, Chamsuddin, A, Finkle, R et al. Blunt cerebrovascular injuries: diagnosis and treatment. J Trauma 2001;51:279–85CrossRefGoogle ScholarPubMed
8Cothren, CC, Moore, EE, Biffl, WL, Ciesla, DJ, Ray, CE, Johnson, JL et al. Anticoagulation is the gold standard therapy for blunt carotid injuries to reduce stroke rate. Arch Surg 2004;139:540–6CrossRefGoogle ScholarPubMed
9Blanchard, R, Hucker, SJ. Age, transvestism, bondage and concurrent paraphilic activities in 117 fatal cases of autoerotic asphyxia. Br J Psychiatry 1991;159:371–7CrossRefGoogle ScholarPubMed
10Byard, RW, Hucker, SJ, Hazelwood, RR. Fatal and near-fatal autoerotic asphyxial episodes in women. Am J Forensic Med Pathol 1993;14:70–3CrossRefGoogle ScholarPubMed
11Byard, RW, Hucker, SJ, Hazelwood, RR. A comparison of typical death scene features in cases of fatal male and female autoerotic asphyxia with a review of the literature. Forensic Sci Int 1990;48:113–21CrossRefGoogle ScholarPubMed
12Hucker, SJ. Self-harmful sexual behavior. Psychiatr Clin North Am 1985;8:323–37CrossRefGoogle ScholarPubMed
13Cothren, CC, Moore, EE, Ray, CE. Carotid artery stents for blunt cerebrovascular injury: risks exceed benefits. Arch Surg 2005;140:480–6CrossRefGoogle ScholarPubMed