Late onset of extensive brain damage and hypertension in a patient with high-voltage electrical burns.

ABSTRACT

An 11-year-old boy sustained high-voltage electrical and flame burns over 85% of his body surface area, 75% of which were full-thickness burns. After 4 months of treatment and multiple operations and skin graftings before his discharge from hospital, he exhibited irritability, hallucinations, and eventually, seizures and respiratory and cardiac arrest. He was resuscitated successfully. Diffuse bilateral brain damage was observed by means of computerized tomography and magnetic resonance imaging. Acute hypertension (up to 290/220 mm Hg) developed the following day. Recovery began 48 hours later. Most clinical symptoms and the hypertension resolved within 1 week. However, the computerized tomographic scans and magnetic resonance imaging findings persisted but were resolved within 2 months. Irritability and low tolerance for frustration were the only remaining symptoms at the time of a 12-month follow-up examination.