A Case of Bilateral Occipital Lobe Infarcts Following Indian Tree Viper Bite

Mahale, Rohan; Mehta, Anish; Javali, Mahendra; Srinivasa, Rakshith

doi:10.5853/jos.2014.16.3.205

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…The physician must be alert to the dynamic spectrum of snake toxin induced injury. Table 4 summarises the various cerebrovascular ischemic manifestations of a hemotoxic snake bite reported by various authors 4, 8, 15–21 .…”

Section: Discussionmentioning

confidence: 99%

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Hemotoxic Snakebite Presenting with Bilateral Blindness Due to Ischemic Occipital Infarcts

John

2019

Indian Journal of Critical Care Medicine

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Cerebrovascular complications are rare following a Viperidae snake envenomation, let alone ischemic ones. This catastrophic hemorrhaging cascade is widely known to cause a wide array of manifestations. Its manifestations can range from skin bleeds to fatal intracranial or organ hemorrhages. Our patient had cortical blindness secondary to an ischemic occipital infarct following a hemotoxic snakebite - a seemingly distinct oxymoron. The physician should be mindful of the fact that a hemotoxic snakebite can deceptively bring in ischemic attacks as well. Toxic vasculitis, thrombotic angiopathies, widespread vasospasm and endothelial damage are believed to shoulder a part of the disease process that can bring about tissue ischemia. Key Messages Hemotoxic snake envenomation can have devastating effects. Apart from dealing with the threat of coagulopathy, the physician must also be alert to the ironical ischemic aftermath that can equally bring in misery. Our patient had one such complication-bilateral cortical blindness resulting from bilateral occipital ischemic infarcts. The physician must be aware that a hemotoxic snakebite can even instigate ischemic dilemmas, i.e. cerebrovascular infarcts, as well. How to cite this article Kodiatte Abraham A, Livingston J. Hemotoxic Snakebite Presenting with Bilateral Blindness Due to Ischemic Occipital Infarcts. Indian J of Crit Care Med 2019;23(2): 99-101.

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Section: Discussionmentioning

confidence: 99%

“…Table 1 lists the reported causes of blindness following snakebite 1–3 . As such, over a dozen reported cases of ischemic strokes following a hemotoxic snake bite were found in the medical literature 4–21 . Cortical blindness was seen in only 4 cases 20–23 .…”

Section: Introductionmentioning

confidence: 99%

Hemotoxic Snakebite Presenting with Bilateral Blindness Due to Ischemic Occipital Infarcts

John

2019

Indian Journal of Critical Care Medicine

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“…, 4 Reports of CVI are seen in 2.6%-4% of patients with snake and scorpion envenomations 5 6 Snakes of Viperidae family including Russel’s viper, Indian green tree viper, Korean viper, species of other pit vipers such as Cerastes, Bothrops and Crotalids are reported to cause complications related to cerebrovascular involvement 7 9 Among all the viper envenomations, reports of CVI are the highest among Russel’s viper envenomation 10 …”

Section: Discussionmentioning

confidence: 99%

“…5,6 Snakes of Viperidae family including Russel's viper, Indian green tree viper, Korean viper, species of other pit vipers such as Cerastes, Bothrops and Crotalids are reported to cause complications related to cerebrovascular involvement. [7][8][9] Among all the viper envenomations, reports of CVI are the highest among Russel's viper envenomation. [10][11][12] Similarly, scorpions such as M. tamulus and Tityus serrulatus have been reported to cause cerebrovascular involvement.…”

Section: Discussionmentioning

confidence: 99%

Cerebrovascular Injury Following Scorpion Sting and Snake Envenomation: A Case Series

Mishra

Binu

Abraham

et al. 2018

Can. J. Neurol. Sci.

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BackgroundNeurological complications following snake and scorpion bite are diverse. Literature regarding patterns of cerebrovascular injury (CVI) and outcomes among these patients is scarce. This is a descriptive study of the clinical profile, brain imaging findings, mechanisms of injury, vascular territory involvement and outcomes of CVI following scorpion and snake envenomation, in a tertiary care center in South India.MethodologyPatients with scorpion sting- and snake envenomation-related complications were retrospectively enrolled. Neuroimaging was performed on five patients with each envenomation, and they were found to have neurological involvement. On imaging, three patients were found to have a CVI. Clinical, radiological parameters and outcomes of these patients were studied. We also performed a review of the literature and analyzed the finding of all the cases.ResultIn all, three patients each had evidence of CVI in imaging. An additional 32 reports of scorpion sting-related CVI and 35 reports of snake envenomation-related CVI were identified from the literature. There was a male predominance among these patients. Mean age of the patients with scorpion sting was 42.8 years as compared with 33 years for the patients with snake envenomation. Features of severe envenomation were present in all patients. Persistently depressed sensorium and new-onset focal neurological deficits were seen in 70% of all patients. Infarcts were seen in 88% of patients with snake envenomation and 53% of patients with a scorpion sting. Mortality was 28% among patients with a scorpion sting as compared with 8% with snake envenomation.ConclusionCerebrovascular injuries are uncommon neurological manifestations following scorpion and snake envenomation. These tend to occur in younger patients. Infarcts are more common than bleeds.

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Bioccipital Lobe Hypoperfusion and Anton's Syndrome Resolution with Intravenous Thrombolysis

Rotkopf

Kunz

Meinel

et al. 2019

Journal of Stroke and Cerebrovascular Diseases

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A Case of Bilateral Occipital Lobe Infarcts Following Indian Tree Viper Bite

Cited by 6 publications

References 7 publications

Hemotoxic Snakebite Presenting with Bilateral Blindness Due to Ischemic Occipital Infarcts

Hemotoxic Snakebite Presenting with Bilateral Blindness Due to Ischemic Occipital Infarcts

Cerebrovascular Injury Following Scorpion Sting and Snake Envenomation: A Case Series

Bioccipital Lobe Hypoperfusion and Anton's Syndrome Resolution with Intravenous Thrombolysis

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