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      Brain hemorrhage after electrical burn injury: Case report and probable mechanism

      case-report

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          Abstract

          Background:

          High-voltage electric injury may induce lesion in different organs. In addition to the local tissue damage, electrical injuries may lead to neurological deficits, musculoskeletal damage, and cardiovascular injury. Severe vascular damage may occur making the blood vessels involved prone to thrombosis and spontaneous rupture.

          Case Description:

          Here, we present the case of a 39-year-old male who suffered an electrical burn with high tension wire causing intracranial bleeding. He presented with an electrical burn in the parietal area (entry zone) and the left forearm (exit zone). The head tomography scan revealed an intraparenchimatous bleeding in the left parietal area. In this case, the electric way was the scalp, cranial bone, blood vessels and brain, upper limb muscle, and skin. The damage was different according to the dielectric property in each tissue. The injury was in the scalp, cerebral blood vessel, skeletal muscle, and upper limb skin. The main damage was in brain’s blood vessels because of the dielectric and geometric features that lead to bleeding, high temperature, and gas delivering.

          Conclusion:

          This is a report of a patient with an electric brain injury that can be useful to elucidate the behavior of the high voltage electrical current flow into the nervous system.

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          Most cited references10

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          Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.

          The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of acute spontaneous intracerebral hemorrhage. A formal literature search of MEDLINE was performed. Data were synthesized with the use of evidence tables. Writing committee members met by teleconference to discuss data-derived recommendations. The American Heart Association Stroke Council's Levels of Evidence grading algorithm was used to grade each recommendation. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Scientific Statements Oversight Committee and Stroke Council Leadership Committee. It is intended that this guideline be fully updated in 3 years' time. Evidence-based guidelines are presented for the care of patients presenting with intracerebral hemorrhage. The focus was subdivided into diagnosis, hemostasis, blood pressure management, inpatient and nursing management, preventing medical comorbidities, surgical treatment, outcome prediction, rehabilitation, prevention of recurrence, and future considerations. Intracerebral hemorrhage is a serious medical condition for which outcome can be impacted by early, aggressive care. The guidelines offer a framework for goal-directed treatment of the patient with intracerebral hemorrhage.
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            The electrical conductivity of human cerebrospinal fluid at body temperature.

            The electrical conductivity of human cerebrospinal fluid (CSF) from seven patients was measured at both room temperature (25 degrees C) and body temperature (37 degrees C). Across the frequency range of 10 Hz-10 kHz, room temperature conductivity was 1.45 S/m, but body temperature conductivity was 1.79 S/m, approximately 23% higher. Modelers of electrical sources in the human brain have underestimated human CSF conductivity by as much as 44% for nearly two decades, and this should be corrected to increase the accuracy of source localization models.
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              Electric injury with cerebral venous thrombosis. Case report and review of the literature.

              A case of accidental electrocution with previously unreported arteriographic evidence of cerebral vein thrombosis is presented. A brief description of early and late neurological complications and current theories attempting to explain the histopathological findings of electric injury are reviewed. The occurrence and persistence of late neurological complications are elucidated. A report of an accidental electrocution with 800 V of alternating current in a young man is presented. Cerebral angiography showed a cerebral vein thrombosis. The immediate complications included loss of consciousness, confusion, memory loss, and headache. Late complications of right-sided clumsiness, sensory loss, hemianopsia, and neglect persisted for more than 1 year despite the brain being outside the current pathway. High-voltage electric injury may cause cerebral vein thrombosis with significant early and delayed brain injury even when the brain lies outside the current pathway.
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                Author and article information

                Contributors
                Journal
                Surg Neurol Int
                Surg Neurol Int
                SNI
                Surgical Neurology International
                Medknow Publications & Media Pvt Ltd (India )
                2229-5097
                2152-7806
                2016
                09 November 2016
                : 7
                : Suppl 28 , SNI: Trauma, a supplement to Surgical Neurology International
                : S759-S762
                Affiliations
                [1 ]Radioneurosurgery Unit, National Institute of Neurology and Neurosurgery, “Dr. Manuel Velasco Suarez”, Mexico City, Mexico
                [2 ]Neurosurgery Department, Medical Center, “Adolfo Lopez Mateos”, Health Institute of Mexico State. Toluca, Mexico State, Mexico
                [3 ]Neurosurgery Department, American British Cowray Medical Center, Mexico City, Mexico
                Author notes
                [* ] Corresponding author
                Article
                SNI-7-759
                10.4103/2152-7806.193728
                5114856
                42ef03f2-271b-43d1-9612-df6fb0f41b6d
                Copyright: © 2016 Surgical Neurology International

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 10 March 2016
                : 25 July 2016
                Categories
                Case Report

                Surgery
                brain,burn,electrical,injury,hemorrhage
                Surgery
                brain, burn, electrical, injury, hemorrhage

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