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Case Reports
. 2011 Oct;14(4):301-3.
doi: 10.4103/0972-2327.91957.

Posterior circulation ischemic stroke following Russell's viper envenomation

Siddalingana Gouda  1 , Vinay Pandit, Shubha Seshadri, Rohith Valsalan, M Vikas
Affiliations
Case Reports

Posterior circulation ischemic stroke following Russell's viper envenomation

Siddalingana Gouda et al. Ann Indian Acad Neurol. 2011 Oct.

Abstract

Ischemic stroke following viper bite is rare. We report a case of posterior circulation ischemic infarction following viper bite in a previously healthy woman. Soon after being bitten by the snake on the left leg, she developed local redness, echymosis and one hour later became drowsy. On examination she had skew deviation of eyes and down gaze preference, generalized hypotonia. A CT scan of brain showed infarcts in cerebellar hemispheres and occipital lobes on both sides and that was confirmed on magnetic resonance imaging of brain. Her coagulation profile was deranged. Most common and serious central nervous system complication following snake bite is intracranial hemorrhage. Ischemic stroke commonly involves anterior circulation. Bilateral cerebellar and occipital infraction is not yet reported in literature. Exact cause for the development of infarction is not clear. The possible mechanisms of infarction in this scenario are discussed. Patient was treated with anti-snake venom and showed a good recovery. Early imaging and early treatment with anti-snake venom is important for a favorable outcome.

Keywords: Viper envenomation; ischemic stroke; posterior circulation.

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Conflict of interest statement

Conflict of Interest: Nil.

Figures

Figure 1
Figure 1
MRI brain (STIR axial) showing bilateral cerebellar infarct
Figure 2
Figure 2
MRI brain (T2W) coronal images showing bilateral cerebellar and occipital infarct
See this image and copyright information in PMC

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