An Autopsy Series: Lightning-related Deaths in Van and Hakkâri Provinces, Turkey

ABSTRACT Objective: To report the largest series of lightning-related deaths in Turkey, to review the literature on this subject, and to identify similarities and differences between the autopsy findings in this study and the information available in literature. Methods: In this study, autopsy reports and crime scene investigation data on 11 lightning-related fatalities that occurred in the Van and Hakkâri Provinces, Turkey, from January 1, 2011 to December 31, 2015 were retrospectively reviewed. Results: Of the 1699 fatalities, 11 (2.53%) evaluated by medico-legal autopsy in the Van and Hakkâri Province in a 5-year period died from lightning strikes. Of these cases, 10 (90.1%) were males and 1 (9.9%) was female (p < 0.05). All cases were in the 11 to 33 years age group. All cases were injured outdoors. Conclusion: We concluded that deaths due to lightning strikes are relatively rare in Turkey, and may be reduced with precautions such as avoiding staying under trees or in the vicinity of high towers, refraining from touching metal objects, avoiding lying on the ground, leaning on walls, and crouching outdoors.

Discusión sobre la necesidad de delimitación de una nueva nosografía psiquiátrica y psicológica. síndrome del accidentado por rayo eléctrico / Discussion on the delimitation of a nosography new psychiatric and psychological need. syndrome of the accident by electric ray

La observación y análisis de las variadas manifestaciones clínicas y secuelas que presentan las víctimas sobrevivientes de accidente por rayo, nos proporciona la posibilidad de cambiar el punto de vista desde el cual consideramos y estudiamos las mismas. Debemos evaluar la conveniencia de considerar tales manifestaciones meramente como un conjunto de signos y síntomas inespecíficos o pertenecientes a múltiples síndromes ya tipificados; o bien, abrir una nueva y profunda discusión en torno a la posibilidad de su agrupación y delimitación de una nueva categoría nosográfica psiquiátrica y psicológica. La metodología de la presente investigación se basa en el análisis de gran parte de la casuística extranjera de estos pacientes y la investigación bibliográfica exhaustiva sobre las escasas publicaciones científicas existentes. Asimismo, se revisan distintos procedimientos habituales en el ingreso de estos pacientes a los centros de salud que dificultan el estudio epidemiológico y sanitario de los mismos.

The observation and analysis of the varied clinical manifestations and sequels surviving accident victims presented by ray, gives us the possibility to change the point of view from which we consider and study them. We must assess the appropriateness of considering such manifestations merely as a set of signs and symptoms nonspecific, or belonging to multiple syndromes already described; Alternatively, open a new and profound discussion about the possibility of their grouping and delimitation of a new category of psychiatric and psychological nosographic. The methodology of this research is based on the analysis of much of the world Casuistry of these patients and the comprehensive bibliographic research on the scarce existing scientific publications. Also reviewed various common procedures in income of these patients to health centers, hindering the health and epidemiological study of them.

Muerte por fulguración / Death by lightning

En el Servicio Provincial de Medicina Legal de Villa Clara, se realizó un estudio descriptivo, longitudinal, retrospectivo, de los fallecidos por fulguración entre el 1ro. de enero de 2009 y el 31 de diciembre de 2014, para determinar sexo, edad y ocupación de los afectados, zona y época del año de mayor ocurrencia, así como las lesiones externas más frecuentes. En el libro de registro y las actas de necropsias, se encontraron 16 fallecidos por esta causa. Predominó el sexo masculino, en la edad laboral; septiembre, mayo y junio fueron los meses de mayor incidencia. Todos los hechos ocurrieron en la zona rural, y el 62,5 %, a la intemperie. La zona noroeste de la provincia resultó la más afectada y las lesiones más frecuentes fueron las quemaduras. Aunque el número de fulguraciones no parece alto, es el fenómeno natural que provoca más muertes en Cuba.

A retrospective, longitudinal and descriptive study of deceased people due to lightning was carried out from January 1st, 2009 to December 31st, 2014 in order to determine gender, age and occupation of the affected individuals, location and time of the year of higher occurrence, as well as, the most frequent external lesions. Sixteen deaths due to this cause were registered in the logbook and in the autopsy reports. Working-age men predominated; the months with the highest incidence were September, May and June. All the incidents happened in rural area, and the 62.5 % was in the outdoors. Northwest region of the province turned out to be the most affected one and burns were the most frequent lesions. Although the number of deaths by lightning doesn't seem to be very high, this is the natural phenomenon that causes more deaths in Cuba.

Pathognomonic symptom associated with lightning strike: Lichtenberg figure

Lightning strikes especially occur during spring and summer months in the afternoons when there is heavy rain. In deaths resulting from lightning strike, there may either be no evidence on the dead person's clothes or body, or there may be burnt or torn patches on their clothes and lichtenberg figures specific to lightning strikes on their bodies. In such cases that also have a comorbid of cognitive dysfunction, since there is generally amnesia, having these figures during the physical examination has a valuable place in early diagnosis and quick treatment. This paper presents a case of lightning strike that was found to have Lichtenberg figures on the back and right leg after secondary examination

A Patient of Lightning Injury Combined with Reversible Neurologic Deficits: A Case Report

Lightning injury can cause systemic deterioration, including neurologic deficits. We present a case of lightning injury with reversible neurologic deficits in a 49-year-old man. Clinical manifestations of neurologic deficits due to lightning injury vary from lightheadedness to paralysis. In order to achieve a favorable outcome, immediate respiratory support and careful neurologic examinations are key elements during initial resuscitation. If secondary injuries due to any type of trauma following lightning were suspected, emergency physicians should make a decision regarding use of advanced diagnostic and therapeutic modalities.

Bilateral macular hole secondary to remote lightning strike.

We report a case of a 16-year-old girl, who was struck by lightning, and experienced blurred vision in the right eye (RE) immediately following the episode. She reported for ophthalmic evaluation two months later. Examination revealed relative afferent pupillary defect in the RE. Posterior subcapsular cataract was noted in both eyes. Fundus examination revealed macular holes and multiple areas of RPE hyperpigmentation in the periphery in both eyes. Fundus fluorescein angiography showed increased choroidal transmission with early fluorescence and late fading in the foveal region and retinal pigment epithelium (RPE) stippling in the periphery in both eyes. This is the first case report of such nature in India to the best of our knowledge.

Cluster headache attacks in a woman previously struck by lightning: pathophysiology of the latent period

BACKGROUND: Cases of patients who developed cluster headache-like symptoms after different putative causes have been reported, indicating a direct relationship between brain lesion and this particular type of headache. Long term, delayed, neurological sequelae after lightning have also been described. CASE REPORT: We describe the case of a woman who, at the age of 10, was struck by lightning. Six years later she developed cluster headache-like attacks. CONCLUSION: We hypothesize that a relationship between the lightning and the cluster headache-like episodes observed in our patient. This case study may have helped throw some light into the still unknown pathophysiology of this particular type of primary headache.

INTRODUÇÃO: Foram descritos casos de pacientes que desenvolveram cefaléia em salvas como manifestação secundária à diferentes causas, indicando uma relação direta entre uma lesão cerebral e este tipo particular de cefaléia. Seqüelas neurológicas tardias após injúria elétrica por raio também têm sido descritas. RELATO DO CASO: Nós descrevemos o caso de uma mulher que aos 10 anos de idade foi atingida por um raio. Seis anos mais tarde desenvolveu sintomatologia de cefaléia em salvas. CONCLUSÃO: Acreditamos que pode haver relação entre a injúria elétrica causada pelo raio e o aparecimento dos episódios semelhantes à cefaléia em salvas observados na nossa paciente. A provável fisiopatologia envolvida na gênese da cefaléia em salvas de origem secundária é discutida, particularmente em relação ao intervalo latente entre a injúria precipitante inicial e a fase álgica da cefaléia.

An unusual case of late ocular changes after lightning injury.

We describe a case of late ocular changes after lightning injury. One year after the injury, complete ankyloblepharon, severe dry eye, corneal opacity, healed iritis and mature cataracts were noted in both eyes of the patient.

A Case of Lightning Burn with Flame Burn / 대한피부과학회지

Lightning injury is uncommon, as evidenced by the fact that most physicians never see or treat such a victim. To our knowledge, there were no reports of lightning burn with flame burn. We report a case of lightning burn with flame burn. On a rainy day, a 64-year-old woman with an umbrella in her left hand was walking along a road. When lightning struck the tip of her umbrella, her clothes were flamed. She threw herself into the water in a nearby field. The fire was extinguished. Then she lost consciousness, but she regained consciousness immediately. She was transported to our hospital. On arrival at our emergency center, her physical examination was remarkable. The patient had an entrance wound of the left palm and an exit wound of the left foot as well as 25 % total body surface burns, which were present in the flexor surface of the left hand, left arm, left leg and left flank. Histopathology showed epidermal and dermal necrosis. Three months later the burns were healed spontaneously, with some remaining scars.

Trauma ocular por raio: relato de 2 casos / Ocular trauma by lighting; report of two cases

Os autores descrevem 2 casos de trauma ocular por descarga elétrica atmosférica, com estudo clínico, angiofluoresceinográfico, eletrofisiológico e campimétrico. A patogênese das múltiplas lesöes na regiäo corneana e coriorretiniana é discutida e a escassa literatura sobre este tipo de trauma, revista

Lightning injury: a case report.

A 40-year-old Thai male was struck by lightning while he was riding his motorcycle during a day of gathering clouds and threatening rain. There were third degree burns around the mastoid areas corresponding to the metal arms of the spectacles, also around the neck where a silver chain with pendant (Buddha image) hung, as well as a full thickness vertical lesion down the center of the chest and abdomen where the zip of the jacket made its mark. Fern-like skin erythema was also seen around the later wound. These are stigmas of lightning skin injuries and the patient survived with no memory of the event.

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.