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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↗
PubMed1977

Lightning injuries.

The course of three patients apparently struck by lightning is reviewed. The circumstances of the injury and the power of the lightning discharge are uncontrollable variables affecting morbidity and mortality. Immediate cardiopulmonary resuscitation followed by careful clinical monitoring and aggressive treatment of involved organ systems will help most patients to complete recovery.

Adult↗
PubMed1994

Lightning strike to the head: case report.

A case is presented of a teen-aged athlete who sustained a direct lightning strike to the head while wearing a football helmet. The helmet, the presence of sweat, and aggressive resuscitation were instrumental in his survival and complete recovery. This appears to be the first documentation of a lightning strike to an individual wearing protective headgear.

Adolescent↗
PubMed1991

Successful management of an adult lightning victim using intracranial pressure monitoring.

Serious central nervous system injuries after lightning strikes are fortunately rare. Optimal neurological and neurosurgical management has not been firmly established. We describe the successful neurological resuscitation and critical care management using intracranial pressure monitoring of an adult who sustained a lightning strike. The role of intracranial pressure monitoring in this setting is discussed.

Coma↗
PubMed2002

Polymer-composite ball lightning.

Investigations into the state of ball lightning (BL) have been made, and both theory and experiments, related to so-called "polymer-composite" ball lightning, are presented. The properties of such a polymeric BL have been described and are that of a long-lived object capable of storing high energy. Results of experiments, starting with polymeric components in erosive gas discharge experiments, are described and discussed. The model of BL as a highly charged polymer-dielectric structure is described. According to this model BL appears as the result of the aggregation of natural polymers, such as lignin and cellulose, soot, polymeric silica and other natural dust particles. Its ability to glow is explained by the appearance over its perimeter of gas discharges near the highly charged BL surface, and electrical breakdown of some regions on the surface, consisting of polymerized and aggregated threads.

Electrochemistry↗
PubMed1998

Lightning injuries during snowy conditions.

Skiers and other snow sports enthusiasts can become lightning casualties. Two such accidents are reported, one being fatal. There are fewer warning signals of impending lightning strikes in winter-like conditions. However, outdoor activists should be aware of at least two suspicious clues: the appearance of convective clouds, and the presence of graupel (snow pellets) during precipitation.

Adult↗
PubMed2004

Epidemiology of electrical and lightning related deaths and injuries among Canadian children and youth.

Among burn injuries, electrical injuries constitute a small but devastating fraction. To describe the epidemiology of electrical injuries in Canadian children, data on deaths and emergency department visits related to electrical injuries, including lightning strikes, were obtained from provincial coroners' offices and the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) respectively, for the years 1991-96. Twenty one deaths and 606 emergency visits highlight that electrical related deaths, more frequent among school age children, are more likely the result of high voltage and lightning strike, while emergency department visits, more frequent among younger children, are more likely the result of low voltage. While the introduction of legislated standards for child safe outlets and educational programs for parents, children, and youth are recommended strategies toward reducing the frequency of these incidents, these strategies require further evaluation before their effectiveness can be estimated.

Accidents, Home↗
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↗
PubMed1997

A bolt from the blue: lightning strike to the head.

We report an extraordinary event of a lightning strike to the head of a helmeted bicyclist that occurred under fair weather conditions with a cloudless sky. The patient sustained a cardiac arrest and hypoxic encephalopathy with residual neurologic impairment. With the availability of highly developed meteorologic equipment, we were able to determine that the lightning "bolt from the blue" probably originated in a thunderstorm that was about 16 km away and obscured by the mountains.

Brain Injuries↗
PubMed1991

Lightning and its effects on the auditory system.

Patients struck by lightning can present with a wide variety of unusual otologic problems including burns to the external auditory canal, tympanic membrane rupture, middle ear injury, and sensorineural hearing loss. Four patients who incurred various otologic problems, including one patient with previously unreported bilateral oval window fistulas following lightning injury, are presented. Audiologic, otologic, and surgical findings are reviewed as well as patient follow-up and outcome.

Adult↗
PubMed2005

Neurorehabilitation of spinal cord injuries following lightning and electrical trauma.

While spinal cord injuries caused by lightning strike or electrical shock are rare, their clinical manifestations pose unique challenges to the clinician who must anticipate the interaction of multiple system involvement with the altered physiology of spinal cord injury. Spinal cord damage may be secondary to the direct effects of electrical current passing through neural tissue producing immediate or delayed impairment. Alternatively, lightning strike and electrical shock may lead to spinal cord damage due to the secondary consequences of injury such as spinal fractures sustained after a fall. In addition to effects on the spinal cord, electrical trauma may result in injury to the brain, peripheral nervous system, musculoskeletal system, skin, and cardiovascular system. This article will review the neurorehabilitation approach to this rare and challenging group of patients.

Humans↗
PubMed2005

Neurorehabilitation of cerebral disorders following lightning and electrical trauma.

The most devastating casualties in lightning and electrical trauma patients are the result of lesions of the nervous system, and especially lesions of the brain. The brain injuries can be divided into three categories: global dysfunction; focal brain injuries; and behavioral-cognitive sequelae without gross physical signs. Lightning injuries are usually the result of outdoor sports and leisure activities. Most electrical trauma cases are the result of workplace accidents. Rehabilitation planning should begin early after the incident and often needs to be continued for a long time. The goal of the rehabilitation team is to maximize functional return in patients with deficits related to brain lesions. The neurorehabilitation team includes the neurorehabilitation physician, physical therapists, occupational therapists, psychologists, speech therapists, and case managers.

Brain Injuries↗
PubMed1991

Lightning fatalities in North Carolina 1972-1988.

Individuals who are outdoors during thunderstorms are at risk for death from direct and indirect lightning hits. Death is more likely from 3:00 p.m. to 8:00 p.m. during the months of May through September. The fatality pattern in North Carolina is similar to that reported for the nation as a whole. Physicians are urged to discuss with their patients simple strategies for reducing exposure to lightning.

Adolescent↗
PubMed1991

Intracranial haematoma resulting from lightning stroke.

Intra-cerebral haemorrhage due to lightning stroke is extremely rare. We report a 45 year old woman who developed intracranial haemorrhage due to a direct lightning stroke. This was proved by CT scan. The haematoma was evacuated surgically, resulting in full neurological recovery of the patient.

Brain Edema↗
PubMed1989

Acute pulmonary oedema caused by lightning.

A case of a 35-year-old housewife who developed acute pulmonary oedema due to the blast effect of lightning is reported. The literature is reviewed and the general effects of lightning are discussed.

Adult↗
PubMed1987

Neurological sequelae of lightning stroke.

Two cases of patients struck by lightning are described. One instance occurred while the victim was using the telephone; the other victim received a direct lightning strike to the head. Both patients had acoustic shock injuries and one developed a cerebral infarct. The mechanisms of these injuries are discussed and the relevant literature is reviewed.

Adolescent↗