In a 35-year-old male found dead after a house fire, the 'split laceration' of the scalp and 'heat haematoma' (epidural collection) must be distinguished from ante-mortem injuries. The key distinguishing feature is:
- A Heat haematoma consists of chocolate-brown, frothy coagulated blood; ante-mortem extradural haematoma is composed of liquid blood with or without clot and may show source (middle meningeal artery) ✓
- B Split lacerations from heat are always anterior; ante-mortem trauma lacerations are posterior
- C Both heat haematoma and ante-mortem extradural haematoma are indistinguishable at autopsy without radiological imaging
- D Heat haematoma only occurs when core body temperature exceeds 200°C
Explanation
Post-mortem heat haematoma (heat extradural haematoma) results from steam formation and bubbling of blood from diploë during heating. It typically has a characteristic chocolate-brown, foamy/frothy, crumbly consistency without an identifiable bleeding source, appears in the temporal or parietal region, and is associated with intact overlying calvarium. Ante-mortem extradural haematoma is typically bi-convex, consists of liquid or clotted red blood, has an identifiable torn meningeal vessel, and is associated with skull fracture in 85% of cases. The frothy, chocolate appearance is the key post-mortem indicator.
Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.
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Written and medically reviewed by the StethoPrep medical team.