A Rare Case Series of Ischemic Stroke Following Russell’s Viper Snake Bite in India

Venkata Krishna Pothukuchi, Alok Kumar, Chennamsetty Teja, Archana Verma

Abstract


Snakebite is an important medical problem in India. Among their various manifestations, cerebral complications are uncommonly found in literature. Moreover, Ischemic stroke following snake bite is quite rare. Here we report a case series of two such cases that developed neurological manifestations following Russell’s viper bite. On computerized tomography (CT) scan of brain; cerebral infarcts were revealed. Their likely mechanisms are discussed in present study which include disseminated intravascular coagulation, toxin induced vasculitis and endothelial damage.


Keywords


ischemic stroke; cerebral infarct; Russel's viper; snake bite

References


David AW. Guidelines for the clinical management of snake-bites in the south-east Asia region. New Delhi: World Health Organization, Regional Office for South East Asia; 2005. p. 1-67.

Warrell DA. Snake venoms in science and clinical medicine. Russell’s viper: Biology, venom and treatment of bites. Trans R Soc Trop Med Hyg. 1989;83:732-40.

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

Mugundhan K, Thruvarutchelvan K, Sivakumar S. Posterior circulation stroke in young male following snake bite. J Assoc Physicians India. 2008;56:713-4.

Mosquera A, Idrovo LA, Tafur A, Del Brutto OH. Stroke following Bothrops spp. snakebite. Neurology. 2003;60:1577-80.

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

Murthy JM, Kishore LT, Naidu KS. Cerebral infarction after envenomation by viper. J Comput Assist Tomogr. 1997;21:35-7.

Marsh NA. Snake venom affecting haemostatic mechanism - A consideration of their mechanism, practical applications and biological significance. Blood Coagul Fibrinolysis. 1994;5:399-410.

Schwartzman RJ, Hill JB. Neurologic complications of disseminated intravascular coagulation. Neurology. 1982;32:791-7.

Biranchni Narayan Mohapatra, CBK Mohanty, Cuttack. Guidelines for Anti Snake Venom Therapy. Medicine Update. 2010;20:426-30.

Deshpande, Rushikesh Prabhakar, et al. Adverse drug reaction profile of anti-snake venom in a rural tertiary care teaching hospital. J Young Pharmacists. 2013:5(2):41-45.

Simpson ID. Snakebite Management in India, the first few hours: A guide for primary care physicians. J Indian Med Assoc. 2007;105:324-35.

Vale Thiago Cardoso, Leite Alysson Ferreira, Hora Priscila Ribeiro da, Coury Marayra Inês França, Silva Ricardo Cipriano da, Teixeira Antônio Lúcio. Bilateral posterior circulation stroke secondary to a crotalid envenomation: case report. Rev Soc Bras Med Trop. 2013;46(2):255-6.

Ranawaka UK, Lalloo DG, de Silva HJ. Neurotoxicity in snakebite-the limits of our knowledge. PLoS Neglected Tropical Diseases. 2013;7(10)e2302.


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