Lightning and the Forensic Pathologist

Abstract

This paper explores the pathology caused by lightning. It covers the basic physics and mechanisms of injury of lightning strikes followed by a short discussion. The purpose of this paper is to suggest an approach to the investigation and autopsy of a lightning-related death.

A shocking injury: A clinical review of lightning injuries highlighting pitfalls and a treatment protocol

“…Acute renal failure (ARF) due to rhabdomyolysis/myoglobinuria and muscle breakdown is rare but must be excluded [1,2,11,17,27,34,48,52].…”

“…Lightning injuries can be classified through seven mechanisms, which are presented in Table 1 [4,9,12,[15][16][17].…”

Neuronal desertification after a direct lightning strike: a case report

“…[2] Injuries due to electricity occur by four mechanisms: a) light; b) direct effect of electrical current on body tissues; c) conversion of electrical energy to thermal energy, resulting in deep and super cial burns; d) blunt mechanical injury from lightning strike, muscle contraction, or as a complication of a fall after electrocution. [17] Light component can injury the eye causing delayed damage such as cataracts (the most common nding) but also more serious and acute issues like macular holes or edema, optic nerve neuropathy and retinal detachment. Conversely, temperatures that rise up to 8,000°C for a few milliseconds are responsible for skin and hair burns.…”

“…Gliomas and cerebral atrophy could also be permanent consequences of lightning shock [21]. There is only a small number of cerebellar syndromes in the literature [21] with a remarkable form of acute atrophy [26] secondary to extensive brain damage, abrupt cerebral salt wasting syndrome has been reported [8][9][10][11][12][13][14][15][16][17] The clinical manifestations of electrical injuries range from mild super cial skin burns to severe multiorgan dysfunction and death. The case we present is an example of severe multi organ involvement presenting with cardiac arrest with rst monitored rhythm asystole, either due to massive myocardial depolarization or as a degradation of ventricular brillation due to several minutes of no ow downtime.…”

Injuries and deaths from lightning

“…The dose would depend on aforementioned six mechanisms. 19 In other words, the dose would depend on the way lightning interacts with the body.…”