Large vessel occlusion stroke in venom-induced consumption coagulopathy after viper envenomation.
Aditya Aryan, Devansh Goyal, Sharique Alam et al.
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Case in brief
A woman in her mid-60s presented with left-sided hemiplegia 6 hours post-viper bite. Investigations revealed profound venom-induced consumption coagulopathy and an acute right middle cerebral artery occlusion. Due to high bleeding risks, standard reperfusion therapies were contraindicated. Management focused on rapid venom neutralisation and supportive care, leading to partial neurological recovery after normalisation of coagulation parameters.
What made this case unusual
The case illustrates the rare occurrence of ischaemic stroke from large-vessel occlusion in the context of active venom-induced consumption coagulopathy, creating a significant therapeutic challenge.
Diagnostic / clinical pearl
Clinicians should be aware that snakebite-induced coagulopathy can complicate the management of ischaemic stroke, necessitating careful consideration of treatment risks.
Why it matters
This case underscores the importance of individualized management strategies in scenarios where ischaemic and haemorrhagic risks intersect, particularly in emergency settings.