At autopsy of a body recovered from a lake, the pathologist notes frank haemorrhage into the air cells of the mastoid bone bilaterally. How should this finding be interpreted?
- A It is evidence of putrefactive artefact and has no diagnostic value
- B It is a recognised sign of vital drowning resulting from barotrauma-like pressure effects ✓
- C It indicates blunt head trauma inflicted before submersion
- D It confirms salt-water rather than fresh-water drowning
Correct answer: B. It is a recognised sign of vital drowning resulting from barotrauma-like pressure effects
Explanation
Haemorrhage into the mastoid air cells and the petrous temporal bone is a described vital reaction in drowning, attributed to the pressure gradient and violent respiratory efforts forcing fluid against the tympanic membrane and middle ear. It supports that the person was alive while submerged. It is not specific to the type of water, does not result from putrefaction, and in isolation does not establish trauma, so it must be weighed with other vital signs such as froth and waterlogged lungs.
Reference: Knight's Forensic Pathology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.