Sait ÖZSOY, Mükerrem SAFALI, Harun TUĞCU, Mehmet TOYGAR

YILDIRIM ÇARPMASINA BAĞLI KAFATASI KIRIĞI; BİR ÖLÜM OLGUSU

Dünyada, günde 8 milyondanfazla yıldırım olayı gerçekleş-mektedir. Yıldırıma bağlı yaralanmalar,%10 ile %30 arasındaölümle sonuçlanmakta, havakaynaklı doğa olaylarına bağlıölüm nedenleri arasında sellerdensonra ikinci sıklıkla yer almaktadır.Yıldırıma bağlı yaralanma sonucuacil servislere başvuran olgularda,subjektif yakınmalar veyastabil vital bulgular saptanabileceğigibi konfüzyon, amnezi, de-ğişik derecelerde yanık, kardiaksorunlar, kafatası kırkları, beyinkanaması saptanabilir. Klinikolarak kafatası kırığı insidansıyıllık 100,000 de 44 olup, en sıkmotorlu araç kazaları sonucundameydana gelmektedir.Olgu, 22 yaşında erkek olup, yıldırımçarpması sonucu yaralanaraköldüğü bildirilmiştir. Ölümuayenesi ve otopside; göğüsön bölgesinde "eğrelti otu" gö-rünümü, vücudun farklı lokalizasyonlarındayanık, kafatasında,sütura sagittaliste ayrılma,sağ parietotemporalde kırık,beyinde epidural, subaraknoidve intraparankimal kanamasaptanmıştır.Bu olgu, yıldırım çarpmasınabağlı nadir saptanan kafatasıkırığı ve kafa içi kanama bulgularınınortaya konularak, acilservislere yıldırım çarpması öyküsüile başvuran olgularda bubulguların ayırıcı tanıda dikkatealınmasının önemini vurgulamakamacı ile sunulmuştur.

SKULL FRACTURE DUE TO LIGHTNING; A DEATH CASE

Every day more than eight million lightnings occur all over the world. 10-30% of lightningrelated injures end in death and when weather-related deaths are examined, it is shown that lightning is the second most common reason after floods. Besides subjective complaints or stable vital signs, victims could be admitted to the emergency department with confusion, amnesia, different degrees of burn, cardiac problems, skull fracture, and cerebral hemorrhage. Normally the incidence of skull fracture is 44/100.000 and motor vehicle accident is the most common cause. The victim was a 22-year-old male and it was reported that lightningrelated injuries had caused his death. Lichtenberg figures on the surface of anterior chest wall, burn lesions on the different part of the body surface, separation of sutura sagittalis, fracture at right temporo-parietal region of scull, epidural, subarachnoidal and cerebral intraparenchymal hemorrhages were determined at postmortem examination and autopsy. This case was presented in order to highlight the importance of rare signs including skull fracture and intracerebral hemorrhage in lightning patients. These signs of patients who are admitted to the emergency department with lightning injuries should be evaluated for the differential diagnosis.

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