Letales Karotissinussyndrom

Report of a case with lethal bleeding into the cervical soft tissue after inadvertent puncture of the carotid artery. After sudden and unexpected cardiac arrest resuscitation was started immediately but intubation failed. Stenosis of the trachea due to hematoma following the puncture was discussed as cause of death as well as thrombembolism and an early septic process. Autopsy revealed an extensive retropharyngeal hematoma but no stenosis of the upper airways. Histological investigations showed extensive bleeding surrounding the sinus caroticum with subcapsular hemorrhages. The sudden onset of the cardiac arrest could have been initiated by a hemorrhage-induced irritation of the sinus caroticum. In the cases reported a lethal irritation of the carotid sinus following external violence has been surmised and there exists only one case report with comparable histological findings from inside and around the glomus caroticum.