Eagle Syndrome and Sudden and Unexpected Death: Forensic Point of View about One Case

Abstract

The causes of sudden death in young adults under the age of 35 are mainly due to cardiovascular issues. We report the case of a 25 year-old man who died suddenly at the wheel of his car, very likely while he was reversing. The autopsy only discovered bilateral ossification of the stylohyoid ligaments. The microscopic and toxicological investigations showed strictly normal results. The cause of death and the circumstances involved in it are discussed under the framework of these ligament anomalies, called “Eagle syndrome”. Indeed, the circumstances involved in the death led to envisaging an abrupt pressure from the vasculonervous structures of the neck on the ossification of the stylohyoid ligaments, during rotation of the neck carried out by the victim due to the accident while reversing. A cardio inhibitory reflex is referred to as the cause of death, but abrupt pressure from the carotid glomeruli cannot be adopted as a contributing factor due to the absence of histological lesions. Moreover, unlike the two cases reported in the forensic literature, and the clinical description of a cerebrovascular accident related to Eagle syndrome, the pressure had to be exercised on the nervusvagus. It is then possible to attribute the cause of death to overstimulation of it whilst in a state of stress.