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PubMedDate not supplied

Myocardial injury due to lightning strike--a case report.

Lightning strike is a natural phenomenon with potentially devastating effects and represents one of the leading causes of cardiac arrest and death from environmental phenomena. Almost every organ system may be impaired as lightning passes through the human body taking the shortest pathways between the contact points. In this paper, the authors report a 38-year-old man who was injured by lightning, a typical example of ;;side splash,'' and had transient electrocardiographic changes.

Adult↗
PubMed2003

Lightning injury in an outdoor swine herd.

Three pigs, weighing 63 kg-70 kg each, from a group of 8 pigs in an outdoor pen that was struck by lightning were necropsied. All 3 pigs presented with hind limb paralysis. The only lesions identified were multiple fractures of the last (seventh) lumbar vertebral body and first sacral vertebral segment, with dorsal displacement of the sacrum and transection of the distal spinal cord and spinal nerves. Hemorrhages extended from the fracture sites into muscles immediately surrounding the lumbosacral junction and retroperitoneally into the pelvic cavity. These hemorrhages were not clearly visible until the pelvic region was dissected. Lesions commonly found in human lightning-strike victims were not present in these pigs. Because vertebral fractures may be the only lesions and may be grossly subtle in heavily muscled pigs, careful pelvic and vertebral dissection is recommended in cases of suspected lightning strike and electrocution.

Animals↗
PubMed2005

A case of takotsubo-shaped hypokinesis of the left ventricle caused by a lightning strike.

A 62-year-old woman was struck by lightning while on a mountain and fortunately did not suffer burns or unconsciousness. She stayed at a mountain lodge overnight and was taken to our hospital by helicopter the next day. Upon admission, electrocardiography showed ST segment elevation indicating acute lateral myocardial infarction, and echocardiography showed takotsubo-shaped hypokinesis of the left ventricle indicating an apical aneurysm. Her serum escaped enzyme levels were increased, as is typical in cases of myocardial infarction, however, she did not complain of cardiac symptoms. Coronary arteriography performed 4 days after admission showed a normal coronary artery while left ventriculography showed apical akinesia. An echocardiogram obtained 2 days later showed resolution of the LV wall motion abnormality. This is the first reported case of takotsubo cardiomyopathy caused by lightning. Takotsubo-shaped hypokinesis is not described as a complication of lightning-induced cardiac injury and its pathogenesis remains controversial.

Aspirin↗
PubMed1990

Lightning strikes.

Lightning strike is a natural phenomenon with potentially devastating effects. The physics of lightning strike and the physiology of lightning injury are discussed. Three cases are reported and the clinical features are described. Aspects of the management of such patients are discussed with particular emphasis on assessment and resuscitation in the Emergency Department.

Adult↗
PubMedDate not supplied

Physeal injury in a lightning strike survivor.

Electrical injuries resulting in physeal injury in children are an uncommon but well-recognized clinical entity. Almost all these injuries are sustained from man-made electrical sources. To date, there have been no published cases of growth arrest after lightning strike. The authors report the case of a 12-year-old girl who survived a lightning strike 2 years ago and who presented with asymmetric growth arrest in both legs. The authors discuss the pathophysiology of lightning strike and consider the evidence for direct electrical injury versus ischemic insult to the physis as explanations for the cause of the growth arrest observed in this patient.

Child↗
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↗
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↗
PubMed2002

Lightning injuries.

Lightning strikes may cause a constellation of injuries. Blunt head trauma, neurologic injury, and cardiac injury are common in these patients. In contrast to high-voltage electrocutions, blunt trauma after a lightning strike is common. Thorough evaluation of all organ systems is crucial. This report discusses mechanism of injury and describes initial evaluation and treatment of lightning strike victims.

Emergency Medical Services↗
PubMed2005

Neurorehabilitation of behavioral disorders following lightning and electrical trauma.

Neurobehavioral problems after lightning and electrical injuries are diverse. Commonly reported are decreased cognitive function, pain syndromes, depression, posttraumatic stress disorder, and significant alterations in social and work roles. While the problems resemble those following other kinds of accidents, the injury scenarios for lightning and electrical trauma are unique, and seem to invite more skepticism and controversy in medical and legal realms when the survivors seek help. Studies of lightning and electrical injuries have identified disabling neuropsychiatric changes for some survivors, often persistent and occasionally progressive, that appear weakly related to litigation status, inconsistently related to injury scenarios, and likely influenced by individual premorbid emotional and coping patterns. Standards of care in the fields of brain injury, behavioral medicine, and psychotherapy can inform rehabilitation strategies. Proper assessment is important, as well as an individualized approach to treatment. Multidisciplinary intervention focuses on managing symptoms, learning compensatory skills, providing psychosocial support, and preventing maladaptive behaviors. It has been therapeutic for some patients to become activists for better awareness and prevention.

Adaptation, Psychological↗
PubMed2005

Lightning Strike and Electric Shock Survivors, International.

Prior to1989 no known support group existed for victims of lightning or electrical shock injury and their families. A lightning strike survivor of twenty years, Steve Marshburn, recognized the need both from his personal experience and after meeting two other survivors. With his wife and psychologist, he formed Lightning Strike and Electric Shock Survivors International. The organization has grown nearly one hundredfold from the thirteen who attended the first annual meeting. The support group serves people from around the world, has produced a number of publications, participated in research about these injuries and has become active in prevention activities. This paper will describe some of the factors that have led to such success for the organization.

Community-Institutional Relations↗
PubMed1990

Temporary bulbar palsy following lightning strike.

Lightning is a significant cause of mortality in Zimbabwe. The same study showed that 21 per cent of fatal lightning strikes occurred with victims inside a hut. We report a case who survived a severe lightning strike with unusual features of a temporary bulbar palsy.

Aged↗
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↗
PubMed1977

Lightning-strike disaster among children.

A lightning strike involving 47 children is described. Four cases demonstrate the most common and serious resulting pathology: burns, myocardial infarction, and neurological symptoms varying from feelings of fear and nightmares to brain death. The pathophysiology of lightning injury is described. The importance of immediate resuscitation of the victim who appears dead after a lightning strike is emphasized, and procedures to prevent lighting injury are presented.

Adolescent↗
PubMed1994

Lightning maculopathy. A case report.

BACKGROUND: Lightning can cause a number of ocular complications. A case involving a patient who developed a cataract and reversible maculopathy in both eyes after being struck by lightning is reported. METHODS: The patient was evaluated for cataract and macular edema by ophthalmoscopic examination, fluorescein angiography, and potential acuity meter. RESULTS: Maculopathy developed that was characterized initially by a retinal cyst with surrounding edema. Later, the lesions evolved to simulate a full-thickness hole. These lesions subsequently resolved, and the patient's visual acuity improved to 20/20 in each eye after cataract extraction. CONCLUSION: Because the visual prognosis for lightning-induced maculopathy is potentially different than that for full-thickness macular holes, careful retinal examination is essential in the preoperative workup.

Adult↗
PubMed1998

Heart donation after lightning strike.

We present the first reported case of heart donation after lightning strike. Approximately 150 to 300 generally young and healthy people die from lightning strike in the United States each year. These unfortunate victims may make good heart donors. Pertinent pathophysiology of lightning strike is briefly reviewed.

Adult↗
PubMed1998

Enhanced positive cloud-to-ground lightning in thunderstorms ingesting smoke from fires

Smoke from forest fires in southern Mexico was advected into the U.S. southern plains from April to June 1998. Cloud-to-ground lightning (CG) flash data from the National Lightning Detection Network matched against satellite-mapped aerosol plumes imply that thunderstorms forming in smoke-contaminated air masses generated large amounts of lightning with positive polarity (+CGs). During 2 months, nearly half a million flashes in the southern plains exhibited +CG percentages that were triple the climatological norm. The peak currents in these +CGs were double the expected value. These thunderstorms also produced abnormally high numbers of mesospheric optical sprites.

Journal Article↗
PubMed1999

[Severe lightning limb pain induced by spinal anesthesia].

We report a case in which spinal anesthesia induced a severe lightning limb pain. A 71-year-old man presented for prostate biopsy. Preanesthetic examinations revealed slight hypesthesia in the L 5-S 1 dermatomal segments in the right leg. The patient reported that he had received "local anesthetic" in the lumbar spine 16 years previously because of severe lumbago, and that his hyposthesia had originated from the "local anesthetic". Unfortunately we had no way to know the anesthetic technique performed 16 years ago. The spinal anesthesia was uneventfully introduced with a 25 G Quincke needle at the L 3-4 interspace using 2.0 ml 0.3% hyperbaric dibucaine in the left lateral positions. As soon as the patient was put into the supine position, he started to complain about severe lightning pain in the region of his hyposthesic segments. Severe lightning pain completely diminished 4 hours later when the effect of spinal anesthesia disappeared.

Aged↗
PubMed1985

Disseminated intravascular coagulation and acute myocardial necrosis caused by lightning.

A 24-year-old woman was struck by lightning and suffered 20% second degree burns. She was admitted after cardiac and respiratory arrest. Despite intensive supportive care she died 24 h later of cardiogenic shock complicated by disseminated intravascular coagulation. At autopsy there was myocardial necrosis. Disseminated intravascular coagulation and myocardial necrosis are only rarely described as complications of lightning.

Adult↗