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PubMedDate not supplied

Childhood lightning injuries on the playing field.

Two young boys were struck by lightning during summer outdoor activities. One of them died. A literature review reveals that the most commonly reported locations of childhood lightning injuries are on the playing field, at the swimming pool, and in tents. Knowledge of measures to lower the risks of lightning strikes as well as the use of new lightning detection technology should help to reduce the numbers of these tragic events in the future.

Adolescent↗
PubMed1992

Acute polyneuropathy due to lightning injury.

The case of a 19 year old man struck by lightning is described. He sustained quadriplegia for several months and fully recovered. It is suggested that his weakness was due to extensive peripheral nerve damage. In addition, he displayed many well recognised medical complications of lightning injury including acute renal failure, rhabdomyolysis, respiratory distress syndrome, autonomic dysfunction, perforated ear drum, uveitis and cataract. The literature relating to the neurology of lightning strike is briefly reviewed.

Acute Disease↗
PubMed1993

Lightning injury of the tympanic membrane.

A number of cases of otologic injuries by lighting strikes have been described in the otolaryngological literature. The mechanism of these injuries remains uncertain. We report 3 cases of lightning injury that presented to us. Analysis of these cases suggests that the mechanism of injury is direct conduction of electricity from the scalp to the soft tissues of the external auditory canal to the tympanic membrane. The conduits of the electrical surge are the subcutaneous blood vessels, smaller vessels being damaged more than larger vessels. Since the tympanic membrane central vessels are smaller than the canal vessels, the central area of the tympanic membrane would be most vulnerable, and this is seen clinically. A review of the literature supports this proposed mechanism of injury.

Adult↗
PubMed2003

Electron paramagnetic resonance spectroscopic evidence of increased free radical generation and selective damage to skeletal muscle following lightning injury.

The present case study examined changes in peripheral markers of free radical metabolism and skeletal/myocardial muscle damage 30 h after a mountaineer had survived a lightning storm, having experienced contact with what was considered to be "upward leaders" at 4200 m. Sea-level control data were available between 3 and 8 weeks prior to the altitude sojourn for comparative purposes. Follow-up measurements were obtained for the same individual 3 weeks following the incident after simulated exposure to the combined stresses of inspiratory hypoxia and physical exercise. Venous blood was assayed for molecular markers of skeletal [myoglobin and total creatine phosphokinase (CPK)] and myocardial [cardiac troponin I (cTnI)] muscle damage. Ex-vivo spin trapping with alpha-phenyl-tert-butylnitrone (PBN) combined with electron paramagnetic resonance (EPR) spectroscopy was incorporated for the direct detection of free radicals. The relative increases [post-exposure/preexposure x 100 (%)] in the concentration of the PBN adduct, myoglobin, and CPK in the "lightning blood" were markedly greater than those observed following the simulation study (PBN: 276 vs. 129%; CPK: 1130 vs. 182%; myoglobin: 205 vs. 115%). In contrast, no changes were observed for cTnI. A marked decrease in the PBN adduct, myoglobin, and CPK was observed within 2 h of completing the simulation study, following oral administration of water and lipid-soluble antioxidant vitamins in normoxia. These findings are the first to document lightning-induced free radical generation and selective damage to skeletal muscle in a high altitude mountaineer. Furthermore, free radicals may contribute to the pathogenesis of lightning injury, and dietary supplementation with antioxidant vitamins may prove of some benefit against associated tissue damage.

Adult↗
PubMed1985

Lightning injuries.

The physical properties of lightning are given, including a description of the different observed lightning forms. The wide variety of effects of lightning on humans is reviewed. In the prehospital care of those struck by lightning, emphasis is upon immediate resuscitation of those who appear unresponsive. Recommendations for emergency department evaluation, treatment, and disposition are given. Guidelines to prevent humans from being struck by lightning are discussed.

Adolescent↗
PubMed1975

Cutaneous manifestations of lightning injury.

This report calls attention to a bizarre, almost pathognomonic, cutaneous feature of lightning injury. It has been variously described as "lightning prints," "arborescent" burns, or "feathering," and has long been neglected in the dermatologic literature. Its recognition may be lifesaving in the unaccompanied comatose patient and is important because even delayed resuscitation of lightning victims can be very successful.

Adult↗
PubMed1996

MRI of lightning injury: early white matter changes associated with cerebral dysfunction.

A previously healthy male was struck by lightning. He developed neurologic deficits, including mild cerebral brain dysfunction. Magnetic resonance imaging (MRI) showed numerous foci of hyperintensity on long TR images, scattered throughout the supratentorial white matter. To our knowledge, the early MRI findings of lightning injury have not been previously reported.

Brain↗
PubMed1973

Lightning injury: two case histories and a review of management.

Two cases of fatal lightning injury are described. Fixed dilated pupils should not be taken as an indicator of death after a lightning strike. Persons who fail to breath spontaneously within one minute of lightning shock should receive external cardiac massage and mouth-to-mouth resuscitation. Paralysis may persist as result of cerebral oedema or prolonged hypoxia-it is therefore suggested that adequate ventilation and metabolic balance should be maintained until recovery or death.

Adolescent↗
PubMed1987

Lightning injury causing prolongation of the Q-T interval.

This case report describes the development of temporary prolongation of the Q-T interval in a patient struck by lightning. A variety of electrocardiographic changes have been documented previously in association with lightning injury; however, the changes in this patient have not previously been reported.

Adult↗
PubMed2001

The long-term consequences of lightning injuries.

The risk of being struck by lightning is extremely low. Although dying instantly through lightning-induced cardiac arrest is a well-documented cause of death, the majority of cases reported in the literature describe infrequently occurring and enormously disparate sequelae of this injury. A total number of 12 patients were treated in our burn intensive care unit following a lightning accident within a period of 12 years. We have analysed the incidence of cardiac, muscular and sensory disturbances, keraunographic skin markings and significant laboratory results, as well as episodes of audiovisual dysfunction and amnesia at the time of the initial admission. In order to determine possible long-term complications, ten of these 12 patients were evaluated at an average time of 6.7 years following the injury (range, 1 month-12.3 years). Considering specific findings during their hospital stay (average length, 1.58+/-0.23 days), patients were assessed for residual neurologic, ocular, oto-vestibular or psychological deficits. The outcome showed that none of the patients suffered from any deficits or long-term problems that could be related to the original lightning injury. Based on these findings and a literature review, we believe that the overall outcome of lightning injuries is more favourable than generally reported.

Adolescent↗
PubMed1986

Lightning injury caused by discharges accompanying flashovers--a clinical and experimental study of death and survival.

During the 17 years preceding March 1985, 140 patients sustained lightning injuries caused by 44 thunderbolts. Fifty patients showed evidence of current flow through their bodies. These 50 victims were classified into two groups, the first consisting of 9 victims who showed rupture of their clothes or linear superficial dermal burns along their whole bodies from head to feet, indicating the occurrence of surface flashovers. The remaining 41 patients showed no evidence of this flash effect. It is noteworthy that in the first group 5 of the 9 survived, whereas in the second group only 6 among 41 survived. The result indicates that when a flashover occurs along the whole body, the probability of survival is higher than 50 per cent. The conditions which determine death or survival were investigated experimentally, imposing artificial lightning voltage impulses on rats and developing flashovers on them. The rats survived when the voltage drop caused by flashover occurred immediately after the peak point, and the current waveform exhibited a sharp peak. In contrast, the rats were killed when the voltage drop caused by flashover was delayed by more than 20 microseconds, and the current waveform showed a blunt cone shape. It has been concluded that a fast flashover appreciably diminishes the energy dissipation within the body and consequently results in survival.

Animals↗
PubMed2001

Lightning injury as a blast injury of skull, brain, and visceral lesions: clinical and experimental evidences.

The present study attempts to better understand the mechanism of injuries associated with direct lightning strikes. We reviewed the records of 256 individuals struck by lightning between 1965 and 1999, including 56 people who were killed. Basal skull fracture, intracranial haemorrhage, pulmonary haemorrhage, or solid organ rupture was suspected in three men who died. Generally these lesions have been attributed to current flow or falling after being struck. However, examination of surface injuries sustained suggested that the true cause was concussion secondary to blast injury resulting from vaporization of water on the body surface by a surface flashover spark. To investigate this hypothesis, an experimental model of a lightning strike was created in the rat. Saline-soaked blotting paper was used to simulate wet clothing or skin, and an artificial lightning impulse was applied. The resultant lesions were consistent with our hypothesis that the blast was reinforced by the concussive effect of water vaporization. The concordance between the clinical and experimental evidence argues strongly for blast injury as an important source of morbidity and mortality in lightning strikes.

Adult↗
PubMed1993

Lightning injury: a case report.

A 40-year-old Thai male was struck by lightning while he was riding his motorcycle during a day of gathering clouds and threatening rain. There were third degree burns around the mastoid areas corresponding to the metal arms of the spectacles, also around the neck where a silver chain with pendant (Buddha image) hung, as well as a full thickness vertical lesion down the center of the chest and abdomen where the zip of the jacket made its mark. Fern-like skin erythema was also seen around the later wound. These are stigmas of lightning skin injuries and the patient survived with no memory of the event.

Adult↗