Limits...
An uncommon initial presentation of snake bite-subarachnoid hemorrhage: A case report with literature review.

Roy MK, Dutta J, Chatterjee A, Sarkar A, Roy K, Agarwal R, Lahiri D, Biswas A, Mondal A, Maity P, Mukhopadhyay J - Ann Indian Acad Neurol (2015 Jul-Sep)

Bottom Line: It can be very fatal if not detected and treated early.Timely intervention can save the patient.Patient was successfully treated with antivenom serum (AVS) along with other conservative management.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.

ABSTRACT
Snake bites are very common in India, particularly in West Bengal. Snake bite can cause various hematological, neuromyopathical complications. It can be very fatal if not detected and treated early. Timely intervention can save the patient. We are reporting a case of hematotoxic Russell viper snake bite presented with subarachnoid hemorrhage. Patient was successfully treated with antivenom serum (AVS) along with other conservative management. Subarachnoid hemorrhage as an initial presentation in viper bite is very rare and we discuss the case with proper literature review.

No MeSH data available.


Related in: MedlinePlus

Magnetic resonance angiography of brain showed normal imaging without any vascular abnormality
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4564475&req=5

Figure 4: Magnetic resonance angiography of brain showed normal imaging without any vascular abnormality

Mentions: Patient was treated immediately with 10 vials of polyvalent antivenom serum (AVS) given over 1 hour, and repeated with 10 vials after 6 hours as the 20 WBCT was abnormal as per WHO guideline of snake bite year 2010. The 20 WBCT normalized subsequently, though the headache persisted without any neurological deficit. Patient was transferred to critical care unit with regular monitoring of the vitals. Patient was treated with mannitol, oral nimodifine and other supportive care as per standard protocol. Routine laboratory investigations revealed a hemoglobin count of 7600, with 78% neutrophils, platelet count of 150000/mm3. Other biochemical parameters like electrolytes, renal function test, liver function test, blood sugar (fasting and postprandial) were within normal limits. Cogulation profile showed prothrombin time (PT) of 13.8 seconds (control 12 s), International normalized ratio (INR) 0f 1.28. Activated partial thromboplastin time (APTT) was 34 seconds (control = 35 s). Fibrin degraded product and D-dimer were 5.6 μg/mL and 1556 ng/mL respectively. Routine urine examination showed microscopic hematuria without any hemoglobinuria. Patient showed gradual improvement in the clinical courses with conservative management. A Magnetic Resonance Angiography (MRA) of brain was done which showed normal vascular anatomy without any structural defect [Figures 3 and 4].


An uncommon initial presentation of snake bite-subarachnoid hemorrhage: A case report with literature review.

Roy MK, Dutta J, Chatterjee A, Sarkar A, Roy K, Agarwal R, Lahiri D, Biswas A, Mondal A, Maity P, Mukhopadhyay J - Ann Indian Acad Neurol (2015 Jul-Sep)

Magnetic resonance angiography of brain showed normal imaging without any vascular abnormality
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4564475&req=5

Figure 4: Magnetic resonance angiography of brain showed normal imaging without any vascular abnormality
Mentions: Patient was treated immediately with 10 vials of polyvalent antivenom serum (AVS) given over 1 hour, and repeated with 10 vials after 6 hours as the 20 WBCT was abnormal as per WHO guideline of snake bite year 2010. The 20 WBCT normalized subsequently, though the headache persisted without any neurological deficit. Patient was transferred to critical care unit with regular monitoring of the vitals. Patient was treated with mannitol, oral nimodifine and other supportive care as per standard protocol. Routine laboratory investigations revealed a hemoglobin count of 7600, with 78% neutrophils, platelet count of 150000/mm3. Other biochemical parameters like electrolytes, renal function test, liver function test, blood sugar (fasting and postprandial) were within normal limits. Cogulation profile showed prothrombin time (PT) of 13.8 seconds (control 12 s), International normalized ratio (INR) 0f 1.28. Activated partial thromboplastin time (APTT) was 34 seconds (control = 35 s). Fibrin degraded product and D-dimer were 5.6 μg/mL and 1556 ng/mL respectively. Routine urine examination showed microscopic hematuria without any hemoglobinuria. Patient showed gradual improvement in the clinical courses with conservative management. A Magnetic Resonance Angiography (MRA) of brain was done which showed normal vascular anatomy without any structural defect [Figures 3 and 4].

Bottom Line: It can be very fatal if not detected and treated early.Timely intervention can save the patient.Patient was successfully treated with antivenom serum (AVS) along with other conservative management.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.

ABSTRACT
Snake bites are very common in India, particularly in West Bengal. Snake bite can cause various hematological, neuromyopathical complications. It can be very fatal if not detected and treated early. Timely intervention can save the patient. We are reporting a case of hematotoxic Russell viper snake bite presented with subarachnoid hemorrhage. Patient was successfully treated with antivenom serum (AVS) along with other conservative management. Subarachnoid hemorrhage as an initial presentation in viper bite is very rare and we discuss the case with proper literature review.

No MeSH data available.


Related in: MedlinePlus