Images in Clinical Medicine

Lichtenberg Figures Due to a Lightning Strike

Yves Domart, M.D., and Emmanuel Garet, M.D.

N Engl J Med 2000; 343:1536November 23, 2000

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Figure 1 A 54-year-old man was struck by lightning and was initially stuporous. The emergency medical team found him conscious and in sinus rhythm, with normal vital signs and numbness and paresthesia of the left shoulder, flank, and leg. On his arrival at the emergency department, he felt well, and an examination revealed a fern-leaf pattern of erythematous, painless cutaneous marks on his left arm, back, buttocks, and left thigh. The electrocardiogram was normal, and the serum concentrations of creatine kinase and myoglobin were slightly elevated. The patient was sent home after 24 hours. On a follow-up visit two days later, he had no traces of the fern-leaf pattern of marks.

Yves Domart, M.D.
Emmanuel Garet, M.D.
Compiègne General Hospital, 60200 Compiègne, France

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   J.F. Arnould, R. Le Floch. (2011) Lichtenberg figures associated with a high-voltage industrial burn. Burns 37:3, e13-e15
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   Gabrielle A. Jacquet, Timothy R. Hurtado. 2011. Lightning and electrical injuries. , 383-394.
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   DAVID WEEDON, GEOFFREY STRUTTON, ADAM I RUBIN. 2010. Reactions to physical agents. , 525-540.
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   Zafer Kilbas, Murat Akin, Semih Gorgulu, Oner Mentes, Erkan Ozturk, Orhan Kozak, Turgut Tufan. (2008) Lightning strike: an unusual etiology of gastric perforation. The American Journal of Emergency Medicine 26:8, 966.e5-966.e7
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   Ken Zafren, Bruno Durrer, Jean-Pierre Herry, Hermann Brugger. (2005) Lightning injuries: prevention and on-site treatment in mountains and remote areas. Resuscitation 65:3, 369-372
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   Michael Cherington, Sheryl Olson, Philip R. Yarnell. (2003) Lightning and Lichtenberg figures. Injury 34:5, 367-371
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   T Muehlberger. (2001) The long-term consequences of lightning injuries. Burns 27:8, 829-833
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   Merrill A. Cohen. (2001) Clinical Pearls Struck by Lightning. Academic Emergency Medicine 8:9, 893-931
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