Lightning strike brain

OBJECTIVE: To report the clinical and mitochondrial genetic analyses of two families, each of which carries both the 11778 and 14484 Leber hereditary optic neuropathy (LHON) mutations in mitochondrial DNA. METHODS: In addition to detailed clinical histories, the complete sequence of the mitochondrial DNA (mtDNA) from each family was determined. RESULTS: A small Australian LHON family (Vic20) and a family from the United States carry the 11778 and 14484 LHON mutations...

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...

Two previously healthy 14-year-old horses developed right-sided unilateral vestibular signs after they had possibly been struck by lightning. Repeated radiographic and endoscopic evaluations did not reveal any significant changes. A brainstem auditory evoked response test indicated a subtle left to right interaural latency difference of waves I, III and V in the more severely affected pony, but its central conduction time remained normal.

Exposure to electrical current via industrial or residential accidents or lightning strikes is a serious and growing concern in today's medical community. The sequelae that result are referred to as electrical injury (EI) or lightning injury (LI). The relevant principles in electricity are reviewed with particular attention given to their damaging capabilities on the body. Specific neuropsychological, psychiatric, and neurological signs and symptoms as well as objective measures of psychological and neuropsychological functioning and brain imaging in victims of EI and LI, are reviewed from past research...

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.

When a person is struck by lightning a spectrum of neurologic damage can result. Approximately one third of the strikes prove to be fatal. The possibility of damage to the CNS relates to the type of lightning injury (direct strike, stride potential, or side flash), the intensity and duration of the current, the pathway of the current within the body, and secondary injuries to brain either from cardiac arrest and hypoxia or from physical trauma. Direct strikes to the head have a high degree of fatality and often result in petechiae or larger brain hemorrhages...

An analysis of 45 victims of fatal lighting strike revealed the incident occurred most frequently in the early afternoon during midsummer in a field of one form or another. The scene of death, damage to clothing, and alterations of metallic objects on the victim are described. A terminal cardiac rhythm of ventricular fibrilation was recorded in half for whom data were available, and asystole was found in 40%. All but four had cutaneous injuries, and nearly one-third had pathognomonic patterns of erythematous arborization...

We describe a case of bilateral basal ganglia hemorrhage after a lightning strike to the head documented by a CT scan. Review of the literature shows this to be the most common brain imaging finding that can be attributed to a lightning strike. Several mechanistic theories are discussed, with the most plausible one being related to preferential conduction pathways through the brain.

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Wallenberg's Syndrome (WS) is exceptional in childhood. We present a case of a 10 year-old girl with a WS caused by an embolism in the right lateral portion of the medulla secondary to an electrofulguration, but with an unusual progressive outcome, developing clinical signs of medial medullar injury, leading even into a respiratory failure 30 days after admittance. She only became stable after surgical lesion decompression. There was no evidence of vascular malformation, finding only a great oedema. The pathology only showed changes compatible with brain infarction...

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.

Serial creatine phosphokinase (CPK) isoenzyme determinations were taken in an 8-year-old boy whose being struck by lightning resulted in prolonged cerebral anoxia, inferolateral myocardial infarction and death. All three isoenzyme levels (CPK-MM, CPK-MB, and CPK-BB) were elevated. The CPK-BB isoenzyme level increase was transient, being very high three hours postlightning strike and disappearing at approximately 24 hours.

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.