Acute Cerebral Artery Occlusion Following Levantine Viper (Macrovipera lebetina) Bite: Gács Sign in Snakebite

Acute cerebral thrombotic stroke following a viper snakebite is a rare occurrence. There have been a few documented cases of cerebral infarctions resulting from envenomation by various viper species. However, none of these reports have specifically detailed instances of stroke induced by Macrovipera lebetina envenomation or vessel occlusion without concurrent cerebral infarction. In this study, we present a case of middle cerebral artery (MCA) occlusion in a 56-year-old man who was bitten by a Macrovipera or Vipera lebetina snake. The individual experienced a snakebite on his right foot, leading to subsequent seizure activity and loss of consciousness. Non-contrast computed tomography scan of the brain revealed hyperattenuation of the right MCA, indicating clot occlusion within the artery, commonly referred to as hyperdense MCA sign or Gács sign.