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PubMed1995

Lightning injury of the tympanic membrane.

Lightning injury to the ear is known, but specific reports are lacking. Four patients with tympanic membrane perforations who were managed surgically are reported. Their presentations, evaluations, intraoperative findings, and outcomes are discussed as they relate to the proposed pathogenic mechanisms. The authors' standard wide exposure tympanoplasty approach with two layer tympanic membrane repair is described. The added steps in performing this procedure may be necessary to ensure a good result in this unique group of patients.

Adolescent↗
PubMed2001

Epidemiology, morbidity, mortality and treatment of lightning injuries in a Turkish burns units.

Deaths from lightning injuries are infrequent--0.2-0.8 per million per year. The victims are mostly young, active people who are struck during various outdoor activities in the summer months. From November 1975 to October 1998; 22 lightning burns were treated in Ankara Numune Teaching and Research Hospital. The mean age of the patients was 32.9 (12-65) years, the female/male ratio 9/13 and the mean duration of hospital stay 15.4 (1-62) days. The commonest clinical symptoms were confusion, amnesia (5 patients), neurological dysfunction (2 patients), cystitis (4 patients), and cardiac arrhythmias (1 patient). There were no deaths. Sixteen surgical procedures were carried out on 14 patients; this was significantly fewer than from any other cause of burns. The commonest long-term complication was chronic pain. Because complications are frequently seen in lightning injuries, our results revealed that patients should be hospitalised and treated as soon as possible after the accident with fluid resuscitation, cardiac resuscitation, tetanus prophylaxis and antibiotics where necessary.

Adolescent↗
PubMed2006

[Lightning injuries: case report of a 17-year-old man and a brief review of the literature].

Lightning injury is one of the most frequent injuries caused by a natural phenomenon, but the risk of being struck by lightning is low. The most vulnerable subjects for lightning injuries are individuals who work in open fields. Although lightning injuries may involve all organ systems, injuries to the cardiovascular system and central nervous system are the most frequent. Burns, tinnitus, blindness and secondary blunt trauma have also been reported. Even though immediate death through lightning-induced cardiac arrest is well documented, the majority of cases reported in the literature describe infrequent and enormously disparate sequelae.A 17-year-old man was admitted to our hospital approximately 3 h after a lightning strike. The Glasgow coma scale was recorded as 15/15 and partial thickness burns totaling of 11% were present on the chest, stomach and right and left lower leg. The entry point was approximately the right side of the neck and the current exited through the right foot. On arrival, the patient's vital signs were normal. Cardiac and pulmonary examinations were within normal limits. The patient suffered transient symptoms, including pain, loss of consciousness, tinnitus, iritis and paresthesia. The laboratory data obtained on admission were within normal limits except serum for WBC, CK, CK-MB, troponin and CRP. We postulate that the mechanism by which lightning caused injury to this patient was a flash discharge (side splash). During his stay in hospital, a debridement of the burn surface following graft coverage and Z-plasty to close the dehiscent wound on the right neck was performed. The patient was discharged from the hospital after 14 days.

Adolescent↗
PubMed2002

A fifth mechanism of lightning injury.

The four classic electrical mechanisms of lightning injury cannot account for all injuries. A fifth mechanism, injury by a weak upward streamer that does not become part of a completed lightning channel, has long been postulated in the engineering literature by lightning researchers. This paper reports a case of death where injury from a weak upward streamer is strongly suspected following forensic investigation. Neither high voltage nor any of the previously accepted mechanisms of lightning injury can explain this incident.

Diagnosis, Differential↗
PubMed1989

Telephone-mediated lightning injury: an Australian survey.

Each year in Australia, about 60 people report injuries attributable to lightning surges while using a telephone during nearby thunderstorms. This paper presents information about such incidents and describes a retrospective survey of more than 300 telephone users reporting injuries possibly attributable to lightning. Questionnaires yielded 132 usable responses, and the results were analysed to identify the extent and nature of the lightning injuries. These are compared with direct strike injuries. Three distinct telephone-mediated lightning strike syndromes are identified (statistically) among the victims.

Australia↗
PubMed1989

[Myocardial damage following lightning injury].

In a 27-year-old woman, struck by lightning behind the left ear, the ECG showed signs of an acute posterior-lateral myocardial infarction after 1 h of unconsciousness and loss of memory. Her serum enzymes were increased as is typical of myocardial infarction, but the patient did not complain of cardiac symptoms. Besides clear signs of lightning injury, the patient showed a hemorrhage throughout the left breast and transient pericardial effusion was observed by echocardiography. In the course of two months, the ECG revealed a regression to unspecific ST-T-deviations and serum enzymes became normal. TI-201-myocardial-scintigraphy (SPECT), done six days and two months after lightning injury, excluded reversible and irreversible perfusion defects.

Adult↗
PubMed1989

The physical effects of lightning injury.

Several thousand lightning-related injuries occur each year in the United States resulting in nearly 600 deaths. Most incidents involve individual victims; group lightning strikes are rare. Ten soldiers were simultaneously injured in a group lightning strike while on training maneuvers at Fort Benning. Georgia. No deaths or loss of consciousness occurred, although two of the soldiers had amnesia for the event. All of the soldiers were hospitalized and observed for potential lightning-related complications. Ninety percent of the soldiers had first-degree skin burns, and all had focal muscular tenderness. Seventy percent had transient ST segment elevation that resolved. Fifty percent developed creatinine kinase (muscular component) elevation, but none developed myoglobinuria or acute renal failure. No patient had creatinine kinase (myocardial component) elevation. Transient hypertension and tinnitus were noted in 40% and 20%, respectively. No compartment syndromes or ocular manifestations developed. All 10 soldiers recovered uneventfully and returned to full active duty.

Adolescent↗
PubMed1984

Electrical and lightning injuries.

The pathophysiology, types, and treatment of electrical and lightning injuries are discussed in detail. Cases of electrical injury almost always eventually involve litigation. Therefore, careful charting of history and physical findings may save the physician court time later. Care of lightning injuries is very different from that of high voltage injuries.

Burn Units↗
PubMedDate not supplied

Neurologic and neurobehavioral effects of electric and lightning injuries.

There are few studies of the effects of electric and lightning injuries (ELI) on the neurologic and neuropsychological status of injured patients. We reviewed records of fourteen patients with ELI injuries seen at our hospital (12 with high-voltage electric and two with lightning injury). Eight had cardiac arrest after injury, and 10 had neurologic complaints when first evaluated. Eight had normal neuroimaging results. Six had electroencephalograms; four showed abnormal results. Thirteen underwent neuropsychological testing. Twelve (92%) showed cognitive dysfunction including impairments in memory, attention, and affective disturbances (anxiety, depression, irritability, and poor frustration tolerance). Five of 12 (62%) had multiple physically aggressive outbursts, not present before the injury. Patients with cardiac arrest did not differ in neurologic psychologic testing from patients not sustaining cardiac arrest. Patients with ELI who had neurobehavioral symptoms had a coherent syndrome characterized by disturbances in cognition (attention and memory), mood (distress with prominent irritability), and behavior (aggressive outbursts). Serial neurologic and neuropsychological evaluations will aid in better defining the sequelae of ELI.

Adult↗
PubMedDate not supplied

Bilateral cataract following lightning injury.

PURPOSE: To report a case of bilateral cataract with posterior vitreous detachment induced by lightning injury. METHODS: A case report of 30 year old man injured by lightning. RESULTS: The patient developed visually significant bilateral cataract after four years of the initial insult on the scalp. The exit wound was noted on the right foot. Fundus evaluation after cataract extraction revealed posterior vitreous detachment. CONCLUSIONS: Lightning can induce various ocular complications. Decrease in vision due to cataract is usually seen years after the initial lightning injury as the initial changes are in the mid-periphery and often missed in the acute setting. Posterior vitreous detachment induced by lightning can rarely lead to retinal tear formation and subsequently retinal detachment. The severity of entry and exit may not give a true picture of the internal organ damage.

Adult↗
PubMed2004

Skin burn, bilateral iridocyclitis and amnesia following a lightning injury.

PURPOSE: To describe a case of lightning injury restricted to the eyes and facial skin. METHODS: Case history describing the clinical examination of a 54-year-old woman. RESULTS: Following a lightning stroke the patient suffered from a sharply demarcated facial skin burn and bilateral iridocyclitis with raised intraocular pressure. Initially she had amnesia regarding the incident. She recovered on symptomatic treatment, with dry eyes as the only sequela. CONCLUSION: We suggest that a lightning current travelled over the outside of the patient's body facilitated by her wet raincoat, a so-called flash-over. Thereby, she was spared from more severe injury, and only the exposed areas of the face and eyes were affected.

Amnesia↗
PubMed1963

[LIGHTNING INJURY].

Explore the source record for details and available documents.

Electric Injuries↗
PubMed1989

Lightning injuries. A unique treatment challenge.

Care of victims of lightning injury is a unique challenge rarely encountered in most clinical practices. Victims may present without signs or symptoms or, conversely, may present in cardiac arrest. Many have chronic, debilitating sequelae. Physicians caring for these patients either in the field or in the emergency department should be prepared to institute aggressive management techniques. An understanding of lightning physics and injury patterns prevents costly and inappropriate diagnostic tests and treatment.

Electric Injuries↗
PubMed2006

A case of lightning injury with delayed-onset psychiatric and cognitive symptoms.

A case is presented of a man who was struck by lighting but, per his report, developed psychiatric and cognitive symptoms between 1-2 years after the incident. The case is discussed in light of the literature on lightning injury with particular emphasis on the aetiology of delayed symptoms. In this case it appears that some cognitive dysfunction may have occurred at the time of the lightning injury, but deficits were exacerbated after a delayed-onset of PTSD and other psychiatric symptoms. The author suggests possible mechanisms for delayed memory impairment in cases of lightning injury.

Adult↗
PubMed2005

Lightning injuries and acute renal failure: a review.

Lightning strikes cause multimodal injuries in victims, and although the number of deaths due to lightning is reportedly in the area of 1,000 deaths per year, they cause significant morbidity in many others. A major complication of a lightning strike is acute renal failure (ARF). The true incidence of ARF due to lightning injuries worldwide is difficult to ascertain because of significant underreporting, due in large measure to cultural and sociodemographic factors. Its incidence is reportedly rare in some literature and significant in others. However, lightning's potential to cause ARF due to myoglobinuria has been noted by many authors. Prompt treatment of myoglobinuric patients prevents the development of ARF. ARF due to direct organ damage by lightning is virtually unheard of. In this article, the current mechanisms of lightning injuries leading to muscle damage, myoglobinuria, and subsequent ARF are discussed, as well as signs and symptoms, laboratory investigations, and patient management.

Acute Kidney Injury↗
PubMed1983

Lightning injury: report of two cases.

Two cases of lightning injury which occurred while mountain climbing and took different clinical courses are reported. One case with lightning marks on the abdomen was treated as a crush injury because of myoglobinuria and elevation of serum glutamic oxaloacetic transaminase, lactic dehydrogenase and creatine phosphokinase. The other case had lightning burns and complained of abdominal pain. He was treated with fluid transfusion resulting from superficial and deep dermal burns estimated at 55 per cent of the body surface and received a skin graft. The subsequent three-year follow-up has revealed no residual deformity in either case.

Adolescent↗