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

Objective. This paper aims to explore the literature about the etiopathogenesis of oculo-sympathetic paresis to increase awareness about the utility of ophthalmological findings in the forensic context of upper neck trauma. Materials and methods. A systematic review of articles published in Medline between 1990 and June 2017 was conducted. Results. A total of 73 peer-reviewed articles were considered suitable. No cases of Bernard Horner syndrome, except one, were reported in the forensic journals. The remaining publications were based on the clinical experiences of living populations. None of them discussed the forensic aspect of the oculo-sympathetic paresis diagnoses. Conclusions. This review encourages medical and legal doctor as well as forensic pathologist to appreciate pupillary abnormalities in living people victims of maltreatment, assault, and surgical complication, as well as in autopsy examinations when a fatal upper neck trauma or pressure is suspected, particularly when no cutaneous or subcutaneous pathological signs are present.