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Brain infarcts due to scorpion stings in children: MRI
A Fernández-Bouzas1, M L Morales-Reséndiz, F Llamas-Ibarra
1Universidad Nacional Autónoma de México, Clemente Orozco 36, México D. F 03710, Mexico. fabouzas@servidor.unam.mx
Abstract:
We report two children with severe neurological complications after having been stung by a scorpion. Clinical and MRI findings suggested brain infarcts. The lesions seen were in pons in one child and the right hemisphere in the other. The latter also showed possible hyperemia in the infarcted area. No vascular occlusions were observed and we therefore think the brain infarcts were a consequence of the scorpion sting. The cause of the infarct may be hypotension, shock or depressed left ventricular function, all of which are frequent in severe poisoning by scorpion sting.
Insights
Severe scorpion stings can cause brain infarcts in children, affecting areas like the pons or hemisphere. These neurological complications may result from systemic effects of the venom, such as shock or cardiac dysfunction.
Area of Science:
- Neurology
- Toxicology
- Pediatrics
Background:
- Scorpion stings are a significant cause of envenomation, particularly in tropical and subtropical regions.
- Severe scorpion envenomation can lead to systemic complications, including cardiovascular and neurological dysfunction.
- Neurological manifestations in children following scorpion stings are less commonly reported but can be severe.
Observation:
- Two pediatric patients presented with severe neurological complications post-scorpion sting.
- Clinical examination and Magnetic Resonance Imaging (MRI) revealed evidence of brain infarcts in both children.
- Lesions were located in the pons in one child and the right cerebral hemisphere in the other.
Findings:
- MRI findings indicated ischemic brain lesions consistent with infarcts.
- One patient exhibited possible hyperemia in the infarcted cerebral hemisphere.
- No evidence of vascular occlusion was identified as the direct cause of the infarcts.
Implications:
- Brain infarcts following scorpion stings in children suggest a direct or indirect neurotoxic effect of the venom.
- Hypotension, shock, or compromised left ventricular function secondary to envenomation are potential mechanisms leading to cerebral ischemia.
- These findings highlight the critical need for prompt recognition and management of cardiovascular and neurological complications in severe pediatric scorpion stings.