A rare case of fatal thalamic hemorrhage with intraventricular extension complicating drowning in an underweight woman

Abstract

Death from natural diseases prior to or after entering the water is relatively rare but does occur. These underlying natural diseases lead to the incapacitation of the water victims and culminate in accidental or unintentional drownings. People who are unaware or ignorant of their disease status, living in rural areas with nearby open water sources, and belonging to economically backward communities in developing countries are more vulnerable to these unintentional drownings and pose a substantial challenge in determining the cause of death. Here we present a 45-year-old, underweight woman who brought a history of drowning in a pond near her house where she regularly took a bath. The history from the relatives and crime scene investigation was unremarkable. Thalamic hemorrhage, intraventricular hemorrhage, triple vessel atherosclerosis of the heart, and left ventricular hypertrophy suggestive of undiagnosed hypertension were discerned only after the autopsy, besides profound findings of drowning. This report highlights the significance of a meticulous autopsy to explain the cause of death in unwitnessed open water drownings, thus benefitting the bystanders and investigating team.