Patient selection: exposure high voltage (>= 1,000 volts)
The passage of electricity through the brain may be suspected based on the wound pattern or electrical path, but often this may not be evident..
Findings that may occur after electrical brain injury:
(1) loss of consciousness
(2) confusion and/or disorientation
(3) poor recall
(4) emotional lability
(5) seizures
(6) diabetes insipidus
(7) neuropathy and/or causalgia
(8) cranial nerve palsy
(9) respiratory arrest
These may appear immediately or be delayed.
Injuries may include:
(1) cerebral coagulative necrosis
(2) epidural and subdural hematomas
(3) intraventricular hemorrhage
(4) subarachnoid hemorrhage
(5) cerebral edema
The authors recommend that any patient with signs of CNS involvement should have:
(1) brain imaging
(2) careful monitoring of vital signs and repeated neurologic examinations in the acute period to detect deterioration
(3) monitoring to detect findings with a delayed onset
