Cerebral venous sinus thrombosis following Russell's viper (Daboia russelii) envenomation: A case report and review of the literature

Ghosh, Ritwik; León-Ruiz, Moisés; Roy, Dipayan; Naga, Dinobandhu; Sardar, Sona Singh; Benito‐León, Julián

doi:10.1016/j.toxicon.2022.08.014

Cited by 8 publications

(10 citation statements)

References 24 publications

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“…In closing, snakebite envenomation can occasionally result in rare but serious atypical complications. 1,17,18 Panhypopituitarism with concurrent central diabetes insipidus may occur following snakebite (especially in Russell's viper envenomation). Early recognition and proper management of these complications are quintessential to preventing further morbidity, impaired quality of life, and mortality.…”

Section: Discussionmentioning

confidence: 99%

Panhypopituitarism and Central Diabetes Insipidus Almost Three Decades After Russell's Viper Envenomation: A Remarkable Case Report and Literature Review

Ghosh

León-Ruiz

Roy

et al. 2022

MRAJ

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Background: Snakebite is a preventable yet often-neglected public health hazard with high chronic disability and mortality, mainly faced by rural communities in the tropics/subtropics. Endocrinological disorders following snakebite (especially Russell's viper in India) are notably underrecognized and can lead to remarkable morbidity, poor quality of life, and cardiovascular mortality. Anterior pituitary insufficiency has been the most common ailment following Russell's viper envenomation amid those endocrinological dysfunctions. On the contrary, the posterior pituitary and nearby hypothalamus mostly remain unharmed, so central diabetes insipidus is extremely rare following a viperid snakebite envenomation. Case Presentation: The authors present a patient developing panhypopituitarism with evident spontaneous central diabetes insipidus 29 years after Russell's viper envenomation. Relevant investigations ruled out other possible etiologies, and he responded well to hormonal replacement therapy. Conclusions: Panhypopituitarism with concurrent central diabetes insipidus may occur following snakebite (especially in Russell's viper envenomation). Early recognition and proper management of these complications are quintessential to preventing further misdiagnosis, under-recognition, morbidity, impaired quality of life, and mortality.

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Section: Discussionmentioning

confidence: 99%

Panhypopituitarism and Central Diabetes Insipidus Almost Three Decades After Russell's Viper Envenomation: A Remarkable Case Report and Literature Review

Ghosh

León-Ruiz

Roy

et al. 2022

MRAJ

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“…CVT can result from several infective and noninfective etiologies. 1,31 However, HIV and HBV, alone or simultaneously, have rarely been attributed as precipitating factors of CVT. Thus, identifying the exact culprit(s) behind CVT in our patient seems to be a riddle arduous to solve.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Thrombosis as The Sole Presenting Manifestation of Human Immunodeficiency Virus and Hepatitis B Virus Co-Infection

Dutta

Ghosh

Pandit

et al. 2022

MRAJ

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Background: Cerebral venous thrombosis (CVT) following either human immunodeficiency virus (HIV) infection or hepatitis B virus (HBV) infection is a very rare condition. Moreover, it has never been reported as the presenting manifestation of HIV and HBV co-infection, even more so when the patient had a normal CD4 count and no demonstrable opportunistic infections. We aimed to report the first case of an adult Indian male, an intravenous drug abuser who developed CVT as the presenting manifestation of HIV-HBV co-infection. Methods: Patient data were obtained from medical records from the Bangur Institute of Neurosciences, Institute of Post Graduate Medical Education and Research & SSKM Hospital, Kolkata, West Bengal, India. Results: A 25-year-old male with a history of intravenous drug abuse and a normal CD4 count developed CVT as the presenting manifestation of HIV-HBV co-infection. His CD4 count was normal, and he had no demonstrable opportunistic infections. He had an uneventful recovery of the condition (CVT) following the institution of conventional anticoagulation therapy alongside anti-retroviral therapy. Conclusion: Whether illicit drug abuse or HIV/HBV infection itself or all in combination led to this thrombotic event cannot be precisely established. Notwithstanding, we recommend serologic testing for HIV and HBV in patients suffering from CVT with high-risk behavior.

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“…The dural venous sinuses, transverse, and superior sagittal sinuses are mostly involved in thrombosis. 1 - 6 CVST is subdivided into 3 subtypes based on the individual’s onset of symptoms: acute CVST is used to describe symptom onset for 48 hours or less; subacute CVST is for when symptoms have been present for at least 48 hours but less than 1 month; and chronic CVST for when symptoms have been present for longer than 1 month. Subacute CVST accounts for most cases of CVST, whilst chronic CVST is reported to be the least common.…”

Section: Introductionmentioning

confidence: 99%

“… 4 Other conditions predisposing to cerebral venous sinus thrombosis are hereditary thrombophilia, birth control, pregnancy, head and neck infections, vasculitis, cancer, dehydration, and obesity. 5 The pathophysiological of CVST is poorly understood. Still, it is proposed that thrombosis leads to increased intracranial pressure, which leads to a cascade involving cytotoxic and vasogenic edema, parenchymal hemorrhage, and hemorrhagic infarction.…”

Section: Introductionmentioning

confidence: 99%

Snakebite Induced Cerebral Venous Sinus Thrombosis: A Case Report

Yousaf

Khan

Anthony

et al. 2023

Clin Med Insights Case Rep

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Introduction: Cerebral venous sinus thrombosis (CVST) is a rare but highly fatal neurological condition mostly caused by prothrombotic conditions like antiphospholipid syndrome, factor V Leiden, and G20210A prothrombin polymorphism. Snake bites are a rare cause of cerebral venous sinus thrombosis that must be recognized and treated promptly to improve survival. Case presentation: We present a case of a 25-year-old male who developed headaches and seizures following a Viper snake bite. The diagnosis was made based on a magnetic resonance venogram (MRV) showing transverse sinus thrombosis with sigmoid sinus stenosis. Initially, the patient was treated with antivenom and supportive treatment for disseminated intravascular coagulation (DIC). After the diagnosis of CVST, the patient was treated with rivaroxaban and levetiracetam. The patient improved within 1 week of treatment and was advised to follow up in 3 months. Conclusion: A high index of suspicion for cerebral venous sinus thrombosis is required if the patient presents with headaches, seizures, or abnormal vision following a snake bite. Early diagnosis and management can prevent further neurological damage.

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Cerebral venous sinus thrombosis following Russell's viper (Daboia russelii) envenomation: A case report and review of the literature

Cited by 8 publications

References 24 publications

Panhypopituitarism and Central Diabetes Insipidus Almost Three Decades After Russell's Viper Envenomation: A Remarkable Case Report and Literature Review

Panhypopituitarism and Central Diabetes Insipidus Almost Three Decades After Russell's Viper Envenomation: A Remarkable Case Report and Literature Review

Cerebral Venous Thrombosis as The Sole Presenting Manifestation of Human Immunodeficiency Virus and Hepatitis B Virus Co-Infection

Snakebite Induced Cerebral Venous Sinus Thrombosis: A Case Report

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