A hypothalamus centred pathogenesis of heat stroke deaths – A postmortem-based human study

Heat stroke deaths are increasing during the summer in tropical countries but the pathogenesis mechanisms are not well established. Postmortem-based human studies in heat stroke cases are few in the literature, which makes post mortem forensic determination of the cause of death extremely difficult. We consider four cases (three male and one female, age range: 40-60 years) who were brought to the mortuary for forensic determination of the cause of death. Autopsy followed standard protocol and gross observations were made. Visceral tissue samples taken for histological staining and microscopic examination. Our observations indicated that the anterior hypothalamus may have a commanding role in the pathogenesis of heat stroke. Acute haemorrhage in the preoptic area of the anterior hypothalamus associated with microvascular injury and acute necrotic lesions of key organs involved in the hemodynamic circulation and temperature control, primarily the heart, lung, kidney and liver should be considered in the forensic determination of the cause of death in such cases.