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非低温情况下与蛛网膜下腔出血相关的反常脱衣现象?

Paradoxical undressing associated with subarachnoid hemorrhage in a non-hypothermia case?

作者信息

Descloux Emilienne, Ducrot Kewin, Scarpelli Maria Pia, Lobrinus Alexander, Palmiere Cristian

机构信息

Centre Universitaire Romand de Médecine Légale, University Centre of Legal Medicine, Lausanne University Hospital, Chemin de la Vulliette 4, 1000, Lausanne, Switzerland.

Division of Clinical Pathology, University Hospital Centre and University of Geneva, Geneva, Switzerland.

出版信息

Int J Legal Med. 2017 Sep;131(5):1341-1345. doi: 10.1007/s00414-017-1597-3. Epub 2017 Apr 25.

Abstract

Paradoxical undressing is a phenomenon characterizing some fatal hypothermia cases. The victims, despite low environmental temperatures, paradoxically remove their clothes due to a sudden feeling of warmth. In this report, we describe a case of suspected paradoxical undressing in a non-hypothermia case. The victim, a 51-year-old Caucasian man, was found dead wearing only sneakers and socks. All other clothing was found in his car. Postmortem investigations allowed the hypothesis of hypothermia to be ruled out and revealed the presence of a ruptured cerebral aneurysm that caused a subarachnoid hemorrhage, the latter responsible for the death. The absence of any elements suggesting a voluntary undressing or any third party's DNA profile or involvement along with the possibility that the subarachnoid hemorrhage might have determined a hypothalamic injury, somehow rendered conceivable the hypothesis of an inappropriate feeling of warmth due to hemorrhage-induced dysregulation of the hypothalamic temperature-regulating centers.

摘要

反常脱衣现象是一些致命低温症病例所特有的现象。受害者尽管身处低温环境,但由于突然感觉温暖,却反常地脱掉衣服。在本报告中,我们描述了一例非低温症病例中疑似反常脱衣的情况。受害者是一名51岁的白人男性,被发现死亡时仅穿着运动鞋和袜子。在他的车里发现了所有其他衣物。尸检调查排除了低温症的假设,并发现存在破裂的脑动脉瘤,导致蛛网膜下腔出血,后者是死亡原因。没有任何表明是自愿脱衣的迹象,也没有任何第三方的DNA特征或参与迹象,同时蛛网膜下腔出血可能导致下丘脑损伤,这使得因出血引起的下丘脑温度调节中枢失调而产生不适当温暖感的假设在某种程度上变得合理。

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