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.