Cochlear implantation for severe sensorineural hearing loss caused by lightning.

Lightning strike can produce an array of clinical symptoms and injuries. It may damage multiple organs and cause auditory injuries ranging from transient hearing loss and vertigo to complete disruption of the auditory system. Tympanic-membrane rupture is relatively common in patients with lightning injury. The exact pathogenetic mechanisms of auditory lesions in lightning survivors have not been fully elucidated. We report the case of a 45-year-old woman with bilateral profound sensorineural hearing loss caused by a lightning strike, who was successfully rehabilitated after a cochlear implantation.

Lightning strike: an unusual etiology of gastric perforation.

Lightning strike is an unusual form of trauma in terms of being one of the leading causes of death from natural phenomenon. Lightning strike can cause severe damage to many systems and results in a high mortality. The most common cause of death in the lightning strike victim is cardiopulmonary arrest. The most vulnerable subjects for lightning strike are individuals who work in open fields, farmers, and swimmers. The cardiac and neurological injuries are the most serious injuries. Burns, tinnitus, blindness, and secondary blunt trauma have also been reported. Gastrointestinal complications have been documented very rarely. In this study, we present a case of gastric perforation after lightning strike. No report related to gastric perforation caused by lightning strike has been identified in the literature.

High tension electrical injury from a telephone receiver.

A high tension (13000 V) electrical injury to a young man from telephone receiver is described. The current entered the telephone circuit due to contact with a high tension live wire running close to the telephone wire 2 km away from the site of incidence.

[Lightning injuries: case report of a 17-year-old man and a brief review of the literature]. / Verletzungen durch Blitzschlag : Fallbeschreibung eines 17-jährigen Patienten und kurze Literaturübersicht.

Lightning injury is one of the most frequent injuries caused by a natural phenomenon, but the risk of being struck by lightning is low. The most vulnerable subjects for lightning injuries are individuals who work in open fields. Although lightning injuries may involve all organ systems, injuries to the cardiovascular system and central nervous system are the most frequent. Burns, tinnitus, blindness and secondary blunt trauma have also been reported. Even though immediate death through lightning-induced cardiac arrest is well documented, the majority of cases reported in the literature describe infrequent and enormously disparate sequelae.A 17-year-old man was admitted to our hospital approximately 3 h after a lightning strike. The Glasgow coma scale was recorded as 15/15 and partial thickness burns totaling of 11% were present on the chest, stomach and right and left lower leg. The entry point was approximately the right side of the neck and the current exited through the right foot. On arrival, the patient's vital signs were normal. Cardiac and pulmonary examinations were within normal limits. The patient suffered transient symptoms, including pain, loss of consciousness, tinnitus, iritis and paresthesia. The laboratory data obtained on admission were within normal limits except serum for WBC, CK, CK-MB, troponin and CRP. We postulate that the mechanism by which lightning caused injury to this patient was a flash discharge (side splash). During his stay in hospital, a debridement of the burn surface following graft coverage and Z-plasty to close the dehiscent wound on the right neck was performed. The patient was discharged from the hospital after 14 days.

Ball lightning burn.

Ball lightning is a rare physical phenomenon, which is not yet completely explained. It is similar to lightning but with different, peculiar characteristics. It can be considered a mix of fire and electricity, concentrated in a fireball with a diameter of 20-cm that most commonly appears suddenly, even in indoor conditions, during a thunderstorm. It moves quickly for several meters, can change direction, and ultimately disappears. During a great storm, a 28-year-old man and his 5-year-old daughter sustained burn wounds after ball lightning came from the outdoors through a chimney. These two patients demonstrated signs of fire and electrical injuries. The father, who lost consciousness, sustained superficial second-degree burn wounds bilaterally on the zygomatic area and deep second-degree burn wounds on his right hand (total body surface area, 4%). His daughter demonstrated superficial second-degree burn wounds on the left part of the face and deep second-degree and third-degree burn wounds (total body surface area, 30%) on the left neck, both upper arms, and the back. In this article, the authors report the first two cases of burn injuries resulting from ball lightning contact indoors. The literature on this rare phenomenon is reviewed to elucidate the nature of ball lightning. Emphasis is placed on the nature of injuries after ball lightning contact, the therapy used, and the long-term complications.

[Anatomic observation of the dorsal metacarpal arteries].

Anastomosis between the first to the fourth dorsal metacarpal arteries was observed in 43 hands of adult corpses. It was found that 86% of the first dorsal metacarpal artery arises from the radial artery, 14% is replaced by the main artery of thumb or superficial branches of the radial arteries; eighty-six percent of the second dorsal metacarpal artery originates from the dorsal carpal artery. Sixty-seven percent of the third and the fourth dorsal metacarpal arteries is formed by anastomosis of the dorsal carpal artery and its deep palmar arch. The first to the fourth dorsal metacarpal arteries have 4 to 8 cutaneous branches and proximal and distal anastomoses. It is concluded that the dorsal metacarpal arteries are characterized with multiple sources and abundant anastomoses around the metacarpophalangeal joints, which can be used with advantage in the repair of soft tissue defects of the area.

Plastic surgical considerations in lighting injuries.

Lightning injuries affect 1,000 to 1,500 people per year in the United States. While fatalities are uncommon, lightning frequently causes injuries within the treatment purview of the plastic surgeon. Recognition of common patterns of lightning injury, their prognosis, and treatments are important for the plastic surgeon. Lightning injury, although electrical, is very different from other more common electrical injuries. Burn injuries are seen, but are usually superficial and heal without surgery. Deep-tissue injury is rare. Neurovascular compromise of the extremities is common and may lead to plastic surgical consultation for intervention. Spontaneous recovery is the rule, however. Several patients are described who illustrate these injuries, and treatment guidelines are proposed.

Malignant melanoma in a burn scar.

Cancers of various sorts are occasionally encountered in burn scars. These lesions are usually squamous cell carcinomas, and the burn scars are usually old. Very rarely, malignant melanoma is encountered. An 87-year-old nursing home patient who had been burned by a lightening strike at age 16 was evaluated. She had sustained a wound covering 2% or 3% of her body surface involving her neck and the upper portion of her anterior trunk that had required several grafts. A lesion was noted over the suprasternal notch approximately 3 months before admission. The biopsy was reported as malignant melanoma. She was subsequently treated by wide reexcision with an associated Z-plasty for neck release. Because of the patient's age and the presence of four areas of regional lymph nodes nearby into which metastasis might spread, no lymph node dissections were carried out. The specimen from the reexcision was reported as squamous cell carcinoma in situ, melanoma in situ, and multinucleated giant cell reaction, acute and chronic infiltrates. The wound margins were clear.