ABSTRACT
The viper is one of India’s most commonly encountered poisonous snakes and envenomation following viper bite usually leads to consumption coagulopathy. Clinical manifestations most frequently include external and internal bleeding. In the setting of viper envenomation, large-vessel thrombosis is a very rare occurrence. Also, bilateral anterior cerebral artery infarction, when unrelated to anatomical abnormalities, subarachnoid haemorrhage, surgery or trauma, itself is an exceedingly rare event. We report a case of a 24-year-old previously healthy man who presented with bilateral anterior cerebral artery infarction following a viper bite. We also present hypotheses that may explain this unusual occurrence. ©
Subject(s)
Adult , Amoxicillin/therapeutic use , Animals , Anti-Bacterial Agents/therapeutic use , Antivenins/therapeutic use , Cerebral Arteries/pathology , Cerebral Infarction/chemically induced , Cerebral Infarction/diagnosis , Clavulanic Acid/therapeutic use , Diuretics, Osmotic/therapeutic use , Factor VIII , Fibrinogen , Humans , Male , Mannitol/therapeutic use , Phenytoin/therapeutic use , Plasma , Snake Bites/complications , Viper Venoms/poisoning , ViperidaeABSTRACT
Neurological deficits can occur following viper bite. It is usually due to intracerebral or subarachnoid bleed as a result of depletion of clotting factors. A healthy 21-year old male developed motor aphasia and right hemiplegia within two hours of being bit by a viper. Brain CT scan revealed a left frontal lobe infarction. The possible mechanisms for cerebral infarction in this patient are hypotension, endothelial injury, hypercoagulability and vascular.