Forensic Pathology for Police - Brainshare Public Online Library

Hypothermia 471
constrict, thus conserving heat by reducing the amount of heat loss via blood flow
in these areas. Increased heat production occurs via reflex muscle shivering and
biochemical thermogenesis.
As hypothermia sets in, the body’s response includes decreased respiratory rate
and heart rate, mental confusion with eventual euphoria, hyperglycemia (increased
blood sugar), and eventual paralysis of the hypothalamus (a deep structure within the
brain responsible for temperature regulation among other things), atrial fibrillation
(a heart arrhythmia), and ventricular fibrillation (a lethal heart arrhythmia).
Scene Investigation
Although hypothermia-related deaths are more likely in extremely cold environmental
temperatures, the environmental temperature does not even have to be below
freezing in order for hypothermia to occur. Recording the local environmental
temperature is an appropriate exercise when any dead body is discovered. When
hypothermia is suspected, investigators should attempt to determine temperatures
during the previous days and nights as well. Particularly in certain geographical
locations, there can be great fluctuations in temperature from daytime to nighttime.
The daytime temperature may be rather warm and pleasant when an investigator is
called to the death scene, even though the previous nighttime temperatures were low
enough to induce hypothermia.
Two specific scenarios may occur in cases of hypothermia. One is referred to as
the “hide and die syndrome,” in which a person who is experiencing hypothermia is
found in a location that gives the impression that they might have been attempting
to “hide.” Examples include bodies being found in a closet, under a bed, or behind
a piece of furniture.
The second scenario that is occasionally encountered in hypothermia deaths
is referred to as “paradoxical undressing.” In this phenomenon, which is likely
related to hypothermia-induced disruption of hypothalamic function, persons dying
of hypothermia begin to remove their clothing. Bodies may be found totally naked
or partially undressed (Fig. 18.1 and Disc Image 18.1). Because of these findings,
it is important to rule out sexual assault in such cases; however, the mere fact that
someone is partially or totally undressed does not mean that there is anything whatsoever
related to sexual activity, or hypothermia for that matter (Disc Image 18.2).
Autopsy Findings
There are no definitive autopsy findings which allow a pathologist to state with
absolute certainty that a person died of hypothermia; however, there are several
features that, taken together, and in the presence of the correct scene and circumstances,
allow pathologists to be fairly confident in their diagnosis. Not all cases
will demonstrate each of these features, but most hypothermia cases will have at
least some of them.