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Posterior circulation stroke in a young male following snake bite
K Mugundhan1, K Thruvarutchelvan, S Sivakumar
1Dept. of Neurology, Govt. Mohan Kumaramangalam Medical College Hospital, Salem-636 001, Tamil Nadu.
The Journal of the Association of Physicians of India
|December 18, 2008
Summary
Snake bites can cause neurological issues like brain bleeds. This case highlights a rare instance where a snake bite led to brain infarction despite normal clotting tests.
Area of Science:
- Neurology
- Toxicology
- Vascular Medicine
Background:
- Snake envenomation is a significant cause of neurological deficits, often linked to coagulopathy and subsequent intracranial hemorrhage.
- Standard diagnostic parameters like clotting time and bleeding time are typically used to assess bleeding risk after snake bites.
Observation:
- A healthy 14-year-old male presented with acute bilateral ptosis and altered sensorium within 3 hours of a snake bite.
- Cerebral Computed Tomography (CT) revealed bilateral cerebellar and right occipital infarction with significant mass effect.
Findings:
- Despite the neurological deficits and infarction, the patient's clotting time and bleeding time were within normal limits.
- This suggests that mechanisms beyond simple factor depletion may contribute to cerebral infarction following snake envenomation.
Implications:
- This case underscores the complex and varied neurological manifestations of snake bites.
- It highlights the need to consider non-hemorrhagic mechanisms, such as infarction, in the differential diagnosis of neurological deficits post-snake bite, even with normal coagulation parameters.
- Further research into the pathophysiology of snakebite-induced infarction is warranted.
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