Cerebral infarction: an unusual manifestation of viper snake bite

Authors

  • Jyotirmoy Pal Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal
  • Sumantro Mondal Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal
  • Debanjali Sinha Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal
  • Tony Ete Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal
  • Atanu Chakraborty Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal
  • Arijit Nag Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal
  • Gouranga Sarkar Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal
  • Bikram Saha Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal

Keywords:

Viper bite, DIC, Cerebral infarction

Abstract

Snake envenomation causes significant mortality and morbidity. Viper bite usually present with local cellulites, renal failure and bleeding disorders. Thrombotic manifestation of snake bite is rarely reported and early administration of Anti-Snake Venom Serum (ASV) also reduces the risk of thrombotic complications. Cerebral infarction in case of viper bite may be due to hypotension, hypercoagulability or direct action of venom on vessel wall. We report a rare case of viper bite, presented with renal failure and cerebral infarction in spite of early ASV institution. The thrombotic manifestation in this case was possibly due to disseminated intravascular coagulation.

References

Hsaini Y, Satte A, Balkhi H, Karouache A, Bourezza A. Stroke following a viper bite. Ann Fr Anesth Reanim. 2010 Apr;29(4):315-6.

Aravanis C, Ioannidis PJ, Ktenas J. Acute myocardial infarction and cerebrovascular accident in a young girl after a viper bite. Br Heart J. 1982 May;47(5):500-3.

Murthy JM, Kishore LT, Naidu KS. Cerebral infarction after envenomation by viper. J Compt Assist Tomogra. 1997 Jan-Feb;21(3):35-7.

Chugh KS. Snake bite induced acute renal failure in India. Kidney Int.1989 Mar;35(3);891-907.

Gawarammana I, Mendis S, Jeganathan K. Acute ischemic strokes due to bites by Daboia russelii in Sri Lanka: first authenticated case series. Toxicon. 2009;54(4):421-8.

Mosquera A, Idrovo LA, Tafur A, Brutto LH. Stroke following Bothrops spp. snake bite. Neurol. 2003 May;60(10):1577-80.

Bashir R, Jinkins J. Cerebral infarction in a young female following snake bite. Stroke. 1985 Mar-Apr;16(2):328-30.

Panicker JN, Madhusudanan S. Cerebral infarction in a young male following viper envenomation. J Assoc Physicians India. 2000 Jul;48(7):744-5.

Hoskote SS, Iyer VR, Kothari VM, Sanghvi DA. Bilateral anterior cerebral artery infarction following viper bite. J Assoc Physicians India. 2009 Jan;57:67-9.

Narang SK, Paleti S, Azeez Asad MA, Samina T. Acute ischemic infarct in the middle cerebral artery territory following a Russell’s viper bite. Neurol India. 2009 Jul-Aug;57(4):479-80.

Gouda S, Pandit V, Seshadri S, Valsalan R, Vikas M. Posterior circulation ischemic stroke following Russell’s viper envenomation. Ann Indian Acad Neurol. 2011 Oct;14(4):301-3.

Ittyachen AM, Jose MB. Thalamic infarction following a Russell’s viper bite. Southeast Asian J Trop Med Pub Health. 2012 Sep;43(5):1201-4.

Vale TC, Leite AF, da Hora PR, Coury MI, da Silva RC, Teixeira AL. Bilateral posterior circulation stroke secondary to a crotalid envenomation: case report. Rev Soc Bras Med Trop. 2013 Mar-Apr;46(2):255-6.

Thomas L, Tyburn B, Bucher B, Pecout F, Ketterle J, Rieux D, et al. Prevention of thromboses in human patients with Bothrops lanceolatus envenoming in Martinique: failure of anticoagulants and efficacy of a monospecific antivenom. Research group on snake bites in Martinique. Am J Trop Med Hyg. 1995 May;52(5):419-26.

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Published

2017-01-24

How to Cite

Pal, J., Mondal, S., Sinha, D., Ete, T., Chakraborty, A., Nag, A., Sarkar, G., & Saha, B. (2017). Cerebral infarction: an unusual manifestation of viper snake bite. International Journal of Research in Medical Sciences, 2(3), 1180–1183. Retrieved from https://www.msjonline.org/index.php/ijrms/article/view/2383