Scorpion bite-induced ischaemic stroke

Area of Science:

• Neuroscience
• Cardiology
• Toxicology

Background:

• Scorpion stings are a significant public health concern, particularly in tropical and subtropical regions.
• While systemic effects are known, severe neurological complications like ischemic stroke are less commonly reported.
• This case examines the intricate relationship between venomous animal encounters and cerebrovascular events.

Observation:

• A 54-year-old female presented with scorpion bite symptoms, rapidly developing tachycardia and hypotension.
• Cardiac investigations revealed myocarditis, evidenced by elevated creatine kinase MB isoenzyme, ECG, and echocardiography.
• Neurological deterioration occurred 12 hours post-bite, manifesting as right hemiplegia, global aphasia, and altered sensorium.

Findings:

• Brain MRI confirmed a massive left middle cerebral artery (MCA) territory infarct.
• Magnetic resonance angiography showed non-visualisation of the left internal carotid artery (ICA) and MCA.
• Normal coagulation parameters suggested a cardioembolic source for the arterial occlusion.

Implications:

• This case underscores the potential for scorpion envenomation to trigger a cardioembolic phenomenon, leading to devastating cerebral infarction.
• It highlights the critical need for comprehensive cardiac and neurological monitoring in patients with severe scorpion stings.
• Understanding these complex pathophysiological pathways is crucial for developing targeted treatments and improving patient outcomes.