Delayed bilateral internal carotid artery thrombosis following accidental strangulation

A 24-yr-old male presented after a fishing accident in which he was pulled underwater by a rope attached to a crayfish pot. He was winched out of the water with the rope still around his neck, sustaining serious neck injuries that ultimately led to his death. After initial resuscitation, he remained fully conscious for approximately 8 h, after which there was a rapid and sudden deterioration in his level of consciousness. The presentation, investigation, management and subsequent postmortem findings are presented and discussed.