Bilateral posterior circulation stroke secondary to a crotalid envenomation: case report

Vale, Thiago Cardoso; Leite, Alysson Ferreira; Hora, Priscila Ribeiro da; Coury, Marayra Inês França; Silva, Ricardo Cipriano da; Teixeira, Antônio Lúcio

doi:10.1590/0037-8682-1667-2013

Cited by 12 publications

(8 citation statements)

References 8 publications

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“…Vale et al 11 reported a case similar to our case—a case of an adolescent who developed bilateral posterior circulation stroke after 1 week of Crotalus durissus terrificus snakebite. The authors concluded that stroke was probably due to toxic vasculitis or toxin‐induced vascular spasm and endothelial damage as the clotting profile was normal when the stroke evolved 11 . In our case, there was no documented hypotension, and there was no evidence of disseminated intravascular coagulation around the time of onset of stroke.…”

Section: Discussionsupporting

confidence: 74%

“…Therefore, it should be given to cases with evidence of systemic envenomation as early as possible. 11,12 In a study which included patients with Bothrops snakebite, no thrombotic complications or stroke was observed in the group with early antivenom therapy within 6 h. 13 Early administration of antivenom may have a role in prevention of thrombotic complications including ischemic stroke.…”

Section: Discussionmentioning

confidence: 99%

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A rare case report of Russell’s viper snakebite with ischemic stroke

Pothukuchi¹,

Chepuri²,

Natta³

et al. 2017

Hong Kong Journal of Emergency Medicine

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Ischemic stroke following snakebite is rare. We report a case of a 55-year-old male who developed headache with expressive aphasia following a Russell's viper bite. Computed tomography scan of the brain revealed infarcts in bilateral frontal lobes. The possible mechanisms for cerebral infarction in this scenario are discussed, which include disseminated intravascular coagulation, toxin-induced vasculitis, and endothelial damage. In viper bites, whenever there is any central nervous system manifestations or deficits, immediate computed tomography scan of the brain should be taken to delineate the underlying pathology, whether hemorrhagic or ischemic, as treatments differ in both situations. Although ischemic stroke is rare in viper bites, if the treatment is started early, the neurological deficits can be minimized.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

A rare case report of Russell’s viper snakebite with ischemic stroke

Pothukuchi¹,

Chepuri²,

Natta³

et al. 2017

Hong Kong Journal of Emergency Medicine

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“…Toxin-induced vascular spasm or toxic vasculitis was the probable cause for the infarct. 9 Angiography did not reveal any abnormality in these patients.…”

mentioning

confidence: 58%

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

et al. 2014

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“…The other clinical manifestations that have been reported are new-onset generalized tonic-clonic seizures, varying motor weakness including hemiplegia, presence of visual field deficit and blindness, giddiness and dysarthria. [27][28][29] Both CT and MRI have been used for confirmation of CVI among these patients. CT brain was performed for 75% of patients with scorpion sting and 53% of patients with snake envenomation in our review.…”

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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Bilateral posterior circulation stroke secondary to a crotalid envenomation: case report

Cited by 12 publications

References 8 publications

A rare case report of Russell’s viper snakebite with ischemic stroke

A rare case report of Russell’s viper snakebite with ischemic stroke

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

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

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