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PubMed2004

[Bilateral plexopathy following lightning injury].

INTRODUCTION: The consequences of lightning injuries on the peripheral nervous system are widely unknown. CASE REPORT: We report on a 31 year-old woman who developed a bilateral brachial plexopathy 15 days after a lightning strike. The patient recovered progressively. CONCLUSION: Peripheral neuropathies due to lightning strikes are probably unrecognized in most of the cases, because occurrence may be delayed and only few patients were adequately investigated. Pathophysiological hypotheses are unclear and lean on experimental studies using electrical current.

Adult↗

PubMedDate not supplied

Ophthalmic manifestations of lightning strike.

Every year in the USA, 100-150 people die and 1000-1500 others are injured by lightning strikes. Ophthalmic and neurologic injuries from lightning strike are common. The most common permanent ocular sequela is cataract, but many areas of the eye can be affected. Prompt evaluation by an ophthalmologist is imperative for maximizing outcomes. Incidence and mechanisms of lightning strike injury are summarized, with special emphasis on the treatment of ocular injuries.

Cataract↗

PubMed2002

[Cardiac injury after indirect lightning strike].

Lightning strike is one of the most frequent causes of death due to natural phenomena. In such cases, cardiac injury is the main cause of death, with type of lesion varying by type of impact. We report the case of a 29-year-old woman who was struck indirectly by lightning. Upon hospital admission, she showed both the echocardiographic disturbances characteristic of direct impact and electrocardiographic disturbances. Both types of change resolved spontaneously. After describing the case, we briefly review the literature on echo and electrocardiographic disturbances after lightning strike.

Adult↗

PubMed1992

Time resolved simulation of lightning by lip.

In this letter, we report results of time resolved spectra of lightning simulation in air by laser-induced plasma (LIP). The measured electron temperatures varied from (1.7 +/- 0.1)X10(4) K at 600 ns to (1.2 +/- 0.1)X10(4)K at 4 microseconds after the ignition of the plasma. Electron densities in the plasma varied from (7.0 +/- 1.4)X10(17)/cm3 to (9.0 +/- 1.8)X10(16)/cm3 for the above times. We also present, for the first time, a comparison of state variables for LIP and natural lightning. We find that immediately following the ignition both natural lightning and LIP reach temperatures in excess of 16,000K and relax to ambient pressure with different rates. They are expected to approach 2000 - 4000 K temperature range, which is important to chemical synthesis, in an asymptotically similar fashion.

Electrons↗

PubMed2001

A possible nitrogen crisis for Archaean life due to reduced nitrogen fixation by lightning.

Nitrogen is an essential element for life and is often the limiting nutrient for terrestrial ecosystems. As most nitrogen is locked in the kinetically stable form, N2, in the Earth's atmosphere, processes that can fix N2 into biologically available forms-such as nitrate and ammonia-control the supply of nitrogen for organisms. On the early Earth, nitrogen is thought to have been fixed abiotically, as nitric oxide formed during lightning discharge. The advent of biological nitrogen fixation suggests that at some point the demand for fixed nitrogen exceeded the supply from abiotic sources, but the timing and causes of the onset of biological nitrogen fixation remain unclear. Here we report an experimental simulation of nitrogen fixation by lightning over a range of Hadean (4.5-3.8 Gyr ago) and Archaean (3.8-2.5 Gyr ago) atmospheric compositions, from predominantly carbon dioxide to predominantly dinitrogen (but always without oxygen). We infer that, as atmospheric CO2 decreased over the Archaean period, the production of nitric oxide from lightning discharge decreased by two orders of magnitude until about 2.2 Gyr. After this time, the rise in oxygen (or methane) concentrations probably initiated other abiotic sources of nitrogen. Although the temporary reduction in nitric oxide production may have lasted for only 100 Myr or less, this was potentially long enough to cause an ecological crisis that triggered the development of biological nitrogen fixation.

Atmosphere↗

PubMed2003

Case report of a 13-year-old struck by lightning.

Lightning strikes kill 1,000 people per year worldwide. Cardiac arrests resulting from lightning strikes have good survival rates but there is a significant degree of morbidity amongst the survivors. This is the case report of a 13-year-old boy who had a cardiac arrest following a direct lightning strike, and his subsequent management.

Adolescent↗

PubMed1995

Neuro-otologic findings in the lightning-injured patient.

Although lightning injuries are common, neuro-otologic sequelae are infrequently reported. The most common otologic injury encountered in the lightning strike victim is tympanic membrane rupture; the most common vestibular disturbance documented is transient vertigo. A variety of other clinical findings have been described in this population of patients. They include sensorineural hearing loss, conductive deafness, tinnitus, basilar skull fracture, avulsion of the mastoid bone, burns to the external auditory canal, and peripheral facial nerve palsy. The initial treatment of the lightning strike victim consists of basic life support measures. Once stabilized, the patient should undergo a complete otologic and vestibular evaluation. The majority of otolaryngologic problems encountered can be managed expectantly, with periodic re-evaluation. Tympanoplasty should be delayed for 6 to 12 months because of the frequent delay in spontaneous healing.

Ear Canal↗

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↗

PubMed2001

Mountain medical mystery. Unwitnessed death of a healthy young man, caused by lightning.

A healthy 20-year-old man failed to return home after a jog in the Colorado mountains. His lifeless body was found the next day on an exposed mountain slope. The differential diagnosis in such mysterious, unwitnessed mountain deaths includes cardiac arrhythmia, cerebral hemorrhage, pulmonary embolism, seizures, trauma, high-altitude sickness, and hypothermia. The cause of death in this case was established on postmortem examination. The findings of ruptured tympanic membranes and a melted shoe established this as a case of lightning strike fatality. The National Lightning Detection Network can be a valuable resource to investigators by providing information on the location and date of lightning strikes in the vicinity of the victim.

Adult↗

PubMed1996

Lightning accident with eight victims: case report and brief review of the literature.

A case of a lightning accident with eight victims is presented. The patients presented with typical injuries, such as cardiocirculatory arrest, apnea, burns, lightning paralysis, and rupture of internal organs. Two of three patients with cardiocirculatory arrest were successfully resuscitated. A brief description of the spectrum of typical lightning injuries, as well as the recommended therapy concepts, are given.

Adult↗

PubMed1999

Lightning strikes at a mass gathering.

Among natural disasters, lightning is a leading cause of morbidity and mortality throughout the world. A well-informed bystander and an astute physician can make the difference between an outcome of death or lifelong disability versus complete or near-complete recovery. What is done in the first few minutes after such an event is the predominant predictor of success. This case report describes a young woman who was struck by lightning while talking on a cellular telephone at a mass gathering in an outdoor stadium. The discussion that follows the case centers on the pathophysiology of being struck by lightning and on issues unique to being struck in a stadium full of people.

Adult↗

PubMed2007

Severe stunned myocardium after lightning strike.

OBJECTIVE: To report the development of myocardial stunning and severe heart failure after lightning strike with total recovery of function. DESIGN: Case report. SETTING: Coronary care unit at Medica Sur Clinic, Mexico. PATIENT: A 42-yr-old woman who was hit by lightning developed rapid and progressive hemodynamic deterioration manifested by cardiogenic shock that required invasive monitoring. Twenty-four hours after the strike, intravenous levosimendan and intra-aortic balloon pump were initiated because the patient demonstrated no significant response to management with conventional inotropic agents. Two days later, echocardiographic signs of systolic and diastolic dysfunction improved markedly. Dual-isotope-imaging myocardial perfusion testing with technetium-99m-sestamibi and thallium-201, performed 9 days after admission, showed normal perfusion and normal left ventricular systolic function. The patient exhibited complete recovery of function. The exact mechanism of abnormal contractility in the absence of direct electrofulguration is unknown but may be explained by release of oxygen free radicals, proteolysis of the contractile apparatus, and cytosolic overload of intracellular calcium, followed by reduced myofilament sensitivity to calcium. These abnormalities are consistent with stunned myocardium. CONCLUSIONS: Lightning strike may cause serious contractile dysfunction in the absence of irreversible myocardial injury, but the exact mechanism of this phenomenon remains unknown. We propose that lighting strike can cause myocardial stunning resulting in severe but reversible left ventricular dysfunction. The patient's recovery was facilitated by support treatment including administration of levosimendan, which increases the intracellular sensitivity to calcium, a mechanism disturbed in patients with myocardial stunning.

Adult↗

PubMed2002

On the energy characteristics of ball lightning.

A compilation of 17 observations of ball lightning showing the most energetic effects is presented along with estimates of their energy content. These observations were chosen from several thousand for the much stronger interaction of each ball lightning on its surroundings, and the method of energy estimation outlined. The case is put that some of the observations show a higher energy than self-contained chemical energy could provide. Comments have been added to the paper, arguing that the energy estimations themselves should be consistent with whatever model is used for ball lightning. For example, the presence of reacting nanoparticles releasing chemical energy may bring about the same observed effects with lower estimated energy.

Electrochemistry↗

PubMedDate not supplied

Fast animation of lightning using an adaptive mesh.

We present a fast method for simulating, animating, and rendering lightning using adaptive grids. The "dielectric breakdown model" is an elegant algorithm for electrical pattern formation that we extend to enable animation of lightning. The simulation can be slow, particularly in 3D, because it involves solving a large Poisson problem. Losasso et al. recently proposed an octree data structure for simulating water and smoke, and we show that this discretization can be applied to the problem of lightning simulation as well. However, implementing the incomplete Cholesky conjugate gradient (ICCG) solver for this problem can be daunting, so we provide an extensive discussion of implementation issues. ICCG solvers can usually be accelerated using "Eisenstat's trick," but the trick cannot be directly applied to the adaptive case. Fortunately, we show that an "almost incomplete Cholesky" factorization can be computed so that Eisenstat's trick can still be used. We then present a fast rendering method based on convolution that is competitive with Monte Carlo ray tracing but orders of magnitude faster, and we also show how to further improve the visual results using jittering.

Algorithms↗

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↗

PubMed1985

Lightning-strike disaster among children.

Thirty-eight children playing or observing a soccer game were the victims of a lightning strike which killed one other child. Interviews with the children and their families documented a number of emotional effects of this disaster, chiefly situational adjustment reactions. The most common reactions involved anxiety, particularly at times of storms. However, the most severely upset children exhibited sleep disturbances, separation anxiety, and nocturnal enuresis. One of two side-flash victims experienced depression for several months; the other experienced no significant emotional upset. Both suffered medical complications and had no memory for the incident. While all children reached at follow-up were doing quite well, those who were most upset by the incident were more likely to refuse to play soccer during the follow-up interval. Stories told to pictures of lightning revealed projections of the children's emotional upset, various defensive reactions to the incident and an increased sense of subjective probability for lightning injuries.

Adaptation, Psychological↗

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↗

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↗