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Emergency Medicine Journal 2004;21:750-751; doi:10.1136/emj.2002.003731
© 2004 BMJ Publishing Group Ltd and the College of Emergency Medicine.

CASE REPORT

Lightning: an unusual cause of cerebellar infarction

S Aslan1, S Yilmaz1 and O Karcioglu2

1 Department of Emergency Medicine, Atatürk University, School of Medicine, Erzurum, Turkey
2 Department of Emergency Medicine, Dokuz Eylül University, School of Medicine, Izmir, Turkey

Correspondence to:
Correspondence to:
Dr S Aslan
Atatürk University, School of Medicine, Department of Emergency Medicine, 25090 Erzurum, Turkey; sahinaslan29{at}hotmail.com

ABSTRACT

The neurological complications of lightning injury are not infrequent. However, scarce data are available on cerebellar infarction attributable to lightning injury. A 45 year old man was admitted to the emergency department because of lightning injury. The patient had a Glasgow coma scale score of 13/15 on arrival at hospital with accompanying dysarthria and hypotonia. Computed tomography of the head showed only a mild cerebral oedema. Ataxia was recorded on the fourth day. Magnetic resonance imaging of the head showed ischaemia predominantly in the cerebellar hemispheres bilaterally and in the parietal, temporal, and frontal lobes on the right. Anti-oedema treatment was started. The patient was discharged after seven days. After one month the patient was re-examined and found to have minimal ataxia and dysarthria. Lightning injury should not be overlooked in the aetiology and differential diagnosis of acute cerebellar ischaemic insult and relevant clinical findings in adults.

Keywords: lightning injury; cerebellar infarction; magnetic resonance imaging


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