Ischemic stroke, an unusual complication of snake bite: case report

Snake bite is the most severe type of envenomation. Annual incidence exceeds six million, with high mortality rates. Viper bites are often responsible for coagulopathy, which causes bleeding disorders. However, ischemic complications are rare. We here report the case of a 6-year-old girl victim of a viper [genus Cerastes] bite in the left ankle. She was admitted with disorders of consciousness and disseminated intravascular coagulation 4 days after the bite. Clinical examination showed left hemiparesis and left lower limb viperin syndrome. Brain CT scan objectified right temporoparietal ischemia. The patient outcome was marked by neurological worsening, requiring mechanical ventilation. Stroke, in particular ischemic stroke secondary to severe snake envenomation, is exceptional. The physiopathological mechanism has not been clearly elucidated but it appears to multifactorial. Then new studies are needed.