|
#1
●
07-11-2014, 09:31 PM
|
|
Lightning Strike Injury
A 60-year-old man was found outside his home, lying rigidly on the ground and unable to move. He was confused and complained of a “buzzing” sound. On emergency department arrival, vital signs were normal, he was alert, and full motor function had returned. Secondary survey revealed intricate, erythematous skin patterns extending from his left arm and axilla (Figure 1, Figure 2) to his back and left leg (Figure 3, Figure 4) . Diagnostic test results, including ECG, creatinine kinase, and cardiac biomarkers, were normal. Dermatologic findings involving the patient's right arm. Dermatologic findings involving the patient's right axilla. Dermatologic findings involving the patient's right thigh. Dermatologic findings involving the patient's right thigh. Diagnosis Lightning strike injury. Lightning strike injury. Two unique findings in this case suggested the diagnosis. His skin findings were classic for Lichtenberg figures, a pathognomonic sign of lightning injury. Lichtenberg figures are transient dermatologic phenomena thought to be caused by accelerated electrons in the epidermis. Often described as “ferning,” they are nonpainful and nonpruritic, blanch with pressure, and leave no residual scar. Our patient also described keraunoparalysis, a temporary state of sensory loss, motor paralysis, and pallor of the extremities caused by acute neurologic injury in combination with significant catecholamine release. Recovery occurs within hours. Lightning kills up to 300 people annually in the United States. Acutely, victims experience neurologic, cardiac, and traumatic complications. Cardiopulmonary arrest leads to mortality in 20% to 30% of cases. Initial resuscitation is the primary goal of medical care, followed by evaluation for secondary injuries. Unfortunately, the majority of survivors are left with some type of deficit such as memory loss, personality change, or chronic pain. Our patient was fortunate to fully recover. |
|
#5
●
07-13-2014, 05:06 AM
|
|
Re: Lightning Strike Injury
Usuaully does.. people that only end up with the Lichtenberg marks are just LUCKY. On a side note? some of the Lichtenberg figures would look pretty gnarly near some of my tattoos.. Hmmn.. storms this week,.. We'll see.. and I have an excuse! I'm certified a Skywarn spotter for the NWS. |