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Table of Contents    
NEUROIMAGE
Year : 2021  |  Volume : 69  |  Issue : 6  |  Page : 1625-1626

Postelectrocution Ischemic Stroke: A Rare and Exceptional Case


1 Second Year Resident, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, Tamil Nadu, India
2 Assistant Professor, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, Tamil Nadu, India
3 Consultant and HOD, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, Tamil Nadu, India

Date of Submission22-Feb-2020
Date of Decision13-Apr-2020
Date of Acceptance22-Jun-2020
Date of Web Publication23-Dec-2021

Correspondence Address:
Dr. Ankita Aggarwal
Duplex No. 1, Sector 15, Behind Unique Plaza, Near HDFC Bank, Vasundhara, Ghaziabad 20102, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.333462

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How to cite this article:
Jain S, Aggarwal A, Malik A. Postelectrocution Ischemic Stroke: A Rare and Exceptional Case. Neurol India 2021;69:1625-6

How to cite this URL:
Jain S, Aggarwal A, Malik A. Postelectrocution Ischemic Stroke: A Rare and Exceptional Case. Neurol India [serial online] 2021 [cited 2022 Jan 26];69:1625-6. Available from: https://www.neurologyindia.com/text.asp?2021/69/6/1625/333462




A 25-year-old male was brought to casualty, unconscious after accidently touching a high-tension voltage wire. On examination, the patient was E2V2M3 with burns on his palm. Blood investigations and ECG were normal. Subsequent MRI, after 19 hours of possible electrical contact, revealed altered T2/FLAIR hyperintensity in bilateral frontal lobes, cingulate gyrus, and bilateral parietal regions along with diffusion restriction in these areas. Time-of-Flight MR angiography showed no signal intensity within the bilateral anterior cerebral arteries [Figure 1]. Bilateral ACA and posterior peripheral watershed territory acute infarction was diagnosed. Possible theories of hypoxic injury to brain post-electrocution are cardiac arrest, dehydration, prolonged tetanic muscle contraction, or vasospasm.[1] The minimal electrical resistance provided by the nervous tissues and blood vessels makes them prone to injury.[2] Review of literature revealed that vasospasm post-electrocution is common (backed by animal studies[3]), but vasospasm causing infarction is rare. Very few reports are published previously depicting acute stroke in electrocution. None of the previously described cases depicted bilateral ACA occlusion as in our case. The prognosis of the injury is good if timely management is instituted; hence, the knowledge of imaging findings of post-electrocution CNS injuries is must. The patient progressively recovered with conservative management and was discharged 7 days later.
Figure 1: (a) Axial T1WI Image shows altered signal intensity areas in bilateral frontal and parietal regions. (b) Axial FLAIR images show T2-FLAIR hyperintense wedge-shaped areas in bilateral frontal and parietal regions. (c and d) ADC with a corresponding DWI map shows diffusion restriction and thus, acute infarct in bilateral ACA territory and peripheral watershed zones. (e and f) ADC with a corresponding DWI map shows diffusion restriction and thus, acute infarct in bilateral ACA territory. (g and h) TOF-MRA show no signal intensity in bilateral ACA

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Huan-Jui Y, Chih-Yang L, Huei-Yu L, Po-Chih C. Acute ischemic stroke in low-voltage electrical injury: A case report. Surg Neurol Int 2010;1:83.  Back to cited text no. 1
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2.
Kokatnur L, Rudrappa M. Acute stroke due to electrocution: Uncommon or unrecognized? Case Rep Neurol Med 2016;2016:9510863.  Back to cited text no. 2
    
3.
Matakas F, Cervós-Navarro J, Roggendorf W, Christmann U, Sasaki S. Spastic constriction of cerebral vessels after electric convulsive treatment. Arch Psychiat Nervenkr 1997;224:1-9.  Back to cited text no. 3
    


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