A Strike from the Air: Cerebral Hemorrhage after a Lightning Strike

Abstract Lightning strikes pose a rare but catastrophic risk for a variety of injuries, including damage to the central nervous system. We present the case of a 79-year-old farmer who survived a lightning strike directly in the chest resulting in an intracerebral hemorrhage in the region of the left basal ganglia. The patient was initially comatose with right-sided paralysis and central facial palsy but displayed gradual improvement with supportive medical therapy. This unique case highlights the potential for lightning strikes to cause rare and severe neurological complications, including intracerebral hemorrhage. A review of the literature proposes possible pathophysiology of lightning-induced intracerebral hemorrhage, but the exact mechanism is yet to be found. Early diagnosis, classification, and treatment of neurological symptoms are crucial for optimal patient outcomes following lightning strikes. This case report adds valuable information to the limited body of literature on lightning strike-induced central nervous system injuries, emphasizing the importance of prompt medical intervention and multidisciplinary care for lightning strike survivors. Further research is needed to better understand the mechanisms underlying lightning-induced intracerebral hemorrhage and to develop optimal treatment strategies for these rare but potentially devastating events.