A sneeze: an unusual trigger for aortic dissection

Upadhyaya, Subramanya; Large, Adrian

doi:10.1136/bcr-2013-200619

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…The sites of injury were classified according to anatomical location: ocular/orbital [3][4][5][6][7][8][9][10][11][12][13][14][15] (27%), intrathoracic [16][17][18][19][20][21][22][23][24][25][26][27][28] (25%), intercranial/neurological 29-38 (19%), laryngeal/pharyngeal [39][40][41][42][43][44][45] (13%), otologic [46][47][48] (6%), and other [49][50][51][52][53] (10%) ( Figure 1). There were 15 cases orbital/ocular injury: orbital subcutaneous emphysema [3][4][5][6][7]10,11,…”

Section: Resultsmentioning

confidence: 99%

“…One patient experienced sudden sensorineural hearing loss, 48 1 patient developed a perilymphatic fistula of the round window, 46 and 1 case described a patient who developed vertigo and headache. 47 Other injuries included aortic dissection 49,53 (2), acute myocardial infarction 52 (1), subcutaneous emphysema over the frontal sinus, 50 and dental implant displacement into the maxillary sinus. 51…”

Section: Resultsmentioning

confidence: 99%

“…Oral contraceptives Fonseca et al 30 Cerebral venous thrombosis F 41 Oral contraceptives St etká rová et al 34 Lower thoracic and back pain, urinary retension, and severe parapresis F 64 Hypertension, aspirin Wu et al 37 Spinal epidural hematoma M 24 van Oosterhout and Haan 36 Migraines without aura M 28 Alvarez et al 29 Heminasal pain attacks with typical migraine features NA NA 51 Discharged a dental implant F 63 Baydin et al 49 Aortic dissection M 51 Hypertension Therrien et al 52 Acute myocardial infarction M 34 Asthma, nasal polyposis, high cholesterol, and cigarette smoking Upadhyaya and Large 53 Type B thoracic aortic dissection M 57 Asthma and gout Abbreviations: F, female; M, male; NA, not available.…”

Section: Unilateral Orbital Emphysema M 30mentioning

confidence: 99%

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The Dangers of Sneezing: A Review of Injuries

Setzen

Platt

2019

Am J Rhinol�Allergy

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Background Sneezing is an almost universal daily phenomenon as a reflex to evacuate irritants from the nasal cavities. An autonomic-controlled buildup of intrathoracic pressure against a closed glottis followed by sudden release results in a burst of 1 kPa of air through the upper airway. Active intervention to limit a sneeze can be deleterious. Closure of the airway during a sneeze can result in over 20 times the airway pressures resulting in a variety of untoward events. This review summarizes all reported injuries that occurred as the result of a sneeze. Objective The objective of this review is to summarize the risks of closed-airway sneezing and determine if there are any trends which can help understand such injuries. Methods A comprehensive literature review was performed from 1948 to 2018 to identify all reports of sneeze-related injuries. Information was compiled from reports to gain insights into comorbidities and risk factors for sneeze injuries. Results There were 52 unique reports of sneeze-related injuries in the literature that were categorized into 6 areas of injury: intrathoracic, laryngeal/pharyngeal, ocular/orbital, intracranial/neurological, otologic, and other. The mean age of subjects who suffered a sneeze injury was 40 years old (range: 15–84 years), with 81% being male gender. Thirty percent had a risk factor for injury of prior trauma (5) or respiratory compromise (5). Conclusion A variety of injuries can occur during a sneeze, especially when a closed-airway sneeze is attempted, and high Valsalva pressure is transmitted to the other systems. Men are more at risk for these injuries with the majority occurring in patients with no known risk factor. When triggered, a sneeze should be allowed to proceed without intervention to prevent associated injuries.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Unilateral Orbital Emphysema M 30mentioning

confidence: 99%

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The Dangers of Sneezing: A Review of Injuries

Setzen

Platt

2019

Am J Rhinol�Allergy

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“…For the Neurologist who may have his/her face in extreme proximity to the patient's face when using the direct ophthalmoscope, the PSR may prove infectious. Sneezing has also been reported to result in rib fractures in osteoporotic patients, spontaneous abortion, ruptured intracranial aneurysm, aortic dissection, intervertebral disc prolapse leading to quadriplegia, and death [4,5].…”

Section: The Photic Sneeze Reflexmentioning

confidence: 99%

Management of the photic sneeze reflex utilising the philtral pressure technique

Bobba

Spencer

Fox

et al. 2019

Eye

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Cerebellar infarction due to the vertebral artery dissection induced sneezing

et al. 2020

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We herein report the rare case of a patient who developed cerebellar infarction due to vertebral artery dissection, initially suspected as a perilymph fistula, immediately after a bout of sneezing. A 61-year-old man developed spontaneous vertigo and tinnitus immediately after a bout of sneezing. Initially there were no obvious findings on head CT, and he was referred to our department as a probable case of peripheral vestibular dysfunction. Since left hearing loss and rightward nystagmus were observed, we initially made the diagnosis of perilymph fistula. However, a repeat CT revealed cerebellar infarction of the region supplied by the posterior inferior cerebellar artery with vertebral artery dissection. This patient had complex mixed symptoms, including peripheral vestibular findings and central nervous system findings. We speculated that this patient might have had infarction of the posterior inferior cerebellar artery region, accompanied by decrease of the blood flow in the anterior inferior cerebellar artery, which caused hearing loss.

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A sneeze: an unusual trigger for aortic dissection

Cited by 3 publications

References 9 publications

The Dangers of Sneezing: A Review of Injuries

The Dangers of Sneezing: A Review of Injuries

Management of the photic sneeze reflex utilising the philtral pressure technique

Cerebellar infarction due to the vertebral artery dissection induced sneezing

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