Neuronal desertification after a direct lightning strike: a case report

Background: Lightning strike is a rare but dramatic cause of injury to patients admitted to Intensive Care units (ICU). High mortality and significant long-term morbidity are frequently related to a direct brain injury or an induced cardiac arrest (CA). Case presentation: We describe the case of a 50 years old man struck by lightning resulting in immediate CA. After the initial restoration of spontaneous circulation and admission to ICU, the patient died in hospital due to neurological injury. The computer tomography scan (CT scan) revealed a massive loss of grey-white matter differentiation at the fronto-temporal lobes bilaterally. Somatosensory evoked potentials demonstrated bilateral absence of the cortical somatosensory N20-potential and the electroencephalogram (EEG) recorded minimal cerebral electrical activity. The patient died on day 10 and a post-mortem study revealed a widespread loss of neurons. Conclusion: This study report a severe brain injury by a direct lighting strike presenting with an impressive microscopic pattern of neuronal desertification.