| Summary: | A potential source of confusion in medicolegal death investigations arises when death from natural causes occurs in circumstances that suggest violence. Consequently, the investigating pathologist is confronted with distinguishing between natural disease and violence or a combination of both. The pathologist should ascertain whether the data collected during the medicolegal death investigations corroborates or contradicts the circumstances surrounding the death. This case report aims to show an approach to cases where death from natural causes occurs under circumstances that suggest that violence. History and circumstances surrounding the death were obtained from the investigating police officer, coroner’s order for postmortem examination, and relatives. A postmortem examination was conducted on the decedent following the practice manual for medicolegal death investigations at the State Forensic Pathologist's Office. We report a case of brain hemorrhage due to ruptured arteriovenous malformation that was reported as a homicide. This case shows the importance of correctly interpreting postmortem findings in determining the cause and the manner of death in criminally suspicious deaths. This case is an example where disease mimics trauma. It is imperative for the pathologists in such instances to search for any possible signs of recent and old injuries that may confirm the violence. The burden of acquiring historical, circumstantial, and medical data to reach valid opinions of the cause and manner of death lies with the pathologist. The cause and manner of death must be expressed so that the criminal justice system is well served.
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