Oculo-sympathetic findings in case of neck trauma. A systematic review

The authors intend to review the pathogenesis of the oculo-sympathetic paresis in case of traumatic upper cervical neck injuries. The importance of miosis and ptosis in a forensic context is rarely considered due to pupillary and eyelid abnormalities that can accompany facial or upper neck trauma without any paresis and for common idea that a large amount of force is needed to disrupt the sympathetic chain and be fatal. The international literature reviewed encourage forensic pathologist to corroborate autopsy findings with postmortem computer tomography or magnetic resonance investigation as well as to study the use of adrenergic ophthalmic agonists to provide additional information. Currently, the reliability of pharmacological testing in forensic autopsy is limited to the estimation of the time of death