Rajesh Reddy Venkata Komatla1, Nagendran C2, Krishna Teja Boggarapu3
Cerebral complications, particularly ischaemic infarcts after snake bites are rare.
Multiple mechanisms are involved in cerebral infarction following snake envenomation. Possible mechanisms include: (1) Anticoagulant and procoagulant effects of snake venom leading to microthrombi, (2) Direct cardiotoxic effects of venom causing dysrhythmias, leading to cardiac thromboembolism and (3) Severe vascular spasm, hypotension and hyperviscosity caused by hypovolaemia. We report a case of a 35-year-old female patient who presented to our casualty with history of snake bite. Following which, she developed bleeding from puncture site with deranged PT INR and anti-snake venom was given. The following day, patient developed right-sided monoplegia with Broca’s aphasia and repeat PT INR came back normal. Imaging showed an ischaemic infarct in left middle cerebral artery territory. Patient was treated accordingly and discharged with residual deficit after a week. Patient is under followup and doing well.