Posterior fossa infarct following Viper bite: a paradox

Deepu D (1), Hrishikesh S (2), Suma MT (3), Zoya V (1)

(1) Department of Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India; (2) Department of Neurosurgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India; (3) Department of Anesthesia, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.

Abstract: Cerebral infarction after a viper bite is relatively uncommon. A combination of factors has been implicated in the pathophysiology of infarct following snakebite. In this case report, the clinical outcome after a posterior circulation infarct and various possibilities that could lead to such a catastrophic event are discussed. The present study stresses the need to keep hydration, blood pressure and central venous pressure optimal in all snakebite patients. Cerebral infarction should be considered a differential diagnosis, in any patient with neurological deterioration following snakebite. Prognosis of such patients with posterior circulation stroke remains poor and decompressive craniectomy has not been found to be helpful.

Key words: snakebite, cerebral infarction, Russell’s viper, posterior cranial fossa.

COPYRIGHT

© CEVAP 2011

SUBMISSION STATUS

Received: April 18, 2011.

Accepted: May 26, 2011.

Abstract published online: May 30, 2011.

Full paper published online: August 31, 2011.

CONFLICTS OF INTEREST

There is no conflict.

CORRESPONDENCE TO

DEEPU DAVID, Department of Medicine II, Christian Medical College and Hospital, Vellore, 632004, Tamil Nadu, India. Phone: +91 416 228 203. Mobile: +91 99940 68478. Email: deepudavid@gmail.com.