Fatal airway compromise due to retropharyngeal hematoma after airbag deployment

In trauma patients it is possible for a hematoma to form in the potential s pace between the pharynx and cervical spine (the retropharyngeal space). Fe wer than 30 cases of actual airway obstruction secondary to retropharyngeal hematomas have been reported. We present an unusual case of an elderly wom an who was involved in a minor motor vehicle collision which deployed her a irbag. She died as a result of anoxic injury to the brain. Autopsy results demonstrated transverse fractures through the bodies of C5 and C7 with asso ciated significant retropharyngeal and mediastinal hematoma. Airbags have b een shown to significantly decrease the mortality rate in frontal collision s; however, the potential for hyperextension injuries from airbag deploymen t exists, especially if the occupant is unrestrained, small, or sitting too close to the airbag. When this woman's airbag deployed, it most likely cau sed her vertebral fractures, hematoma, subsequent airway compromise, and an oxic brain injury. Whatever the mechanism of trauma, one must be cognizant of the potential risk for retropharyngeal hematoma and airway compromise wh en a patient presents with injury to the cervical spine.