Open AccessMassive acute ischemic stroke after Bothrops spp. envenomation in southwestern Colombia: Case report and literature review
Author(s) -
Viviana Alexandra MartínezVillota,
Paulo Francisco Mera-Martínez,
José Darío Portillo-Miño
Publication year - 2022
Publication title -
biomédica/biomedica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.26
H-Index - 28
eISSN - 2590-7379
pISSN - 0120-4157
DOI - 10.7705/biomedica.6114
Subject(s) - medicine , bothrops , envenomation , complication , stroke (engine) , thrombosis , shock (circulatory) , anesthesia , surgery , venom , snake venom , mechanical engineering , ecology , engineering , biology
Bothrops spp. envenomation and its relationship with ischemic stroke has complex pathogenesis. Local effects such as edema, pain, redness, necrosis, and systemic manifestations like coagulation disorders, thrombosis, renal failure, and hemorrhage have been reported. Hemorrhagic stroke is a common neurological complication but ischemic stroke is poorly understood.We present here the case of a 50-year-old male with no comorbidities referred from a rural area in southwest Colombia with a Bothrops spp. snakebite on the left hand. On admission, the patient presented with a deterioration of consciousness and required mechanical ventilation assistance. The MRI showed multiple ischemic areas in the bilateral frontaltemporal and occipital regions. Two months later, the patient had a favorable resolution, although central paresis in the III and VI cranial nerves and positive Babinski’s sign persisted.As already mentioned, the pathophysiology of ischemic stroke due to snakebite is complex but the procoagulant activity of the venom components, the hypovolemic shock, the endothelial damage, and the thromboinflammation can explain it, and although it rarely occurs, it should be considered as a complication of ophidian accidents caused by Bothrops spp.