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Acute ischaemic stroke and deep vein thrombosis following snakebite
  1. Dhriti Sundar Das1,
  2. Rakesh Kumar Mohapatra1,
  3. Rashmi Ranjan Mohanty1 and
  4. Ranjan Kumar Patel2
  1. 1General Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
  2. 2Radiodiagnosis, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
  1. Correspondence to Dr Dhriti Sundar Das; genmed_dhriti{at}aiimsbhubaneswar.edu.in

Abstract

Snakebite envenomation remains a neglected tropical public health issue claiming thousands of lives every year. It is a common medical emergency and a threat to the impoverished populations of low-income and middle-income countries including India. A combination of ischaemic stroke and deep vein thrombosis is a devastating duo complication of snake bite, with no literature report to date. Here, the authors report an unusual case of a young woman developing ischaemic stroke and deep vein thrombosis following snakebite even after the use of antivenom. MRI brain showed right thalamic infarct with haemorrhagic transformation and, ultrasound Doppler revealed right lower limb deep vein thrombosis. The pathophysiology of deep vein thrombosis and ischaemic stroke is complex. It is believed that the activation of the coagulation cascade, complement system together with endothelial injury and immune activation leads to inflammation, thrombosis and occlusion of smaller and even larger vessels.

  • Venous thromboembolism
  • Poisoning

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: DSD, RM, RRM and RKP. The following authors gave final approval of the manuscript: DSD, RM, RRM and RKP.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.