An uncommon case of venomous snake bite complicated by intracranial haemorrhage


  • Anant Parasher Department of Medicine, Guru Teg Bahadur Hospital, New Delhi, India
  • Prabhat Gautam Roy Department of Medicine, Guru Teg Bahadur Hospital, New Delhi, India
  • Soumya Inamadar Department of Medicine, Guru Teg Bahadur Hospital, New Delhi, India



Intracerebral hemorrhage, Neurological sequalae, Snake bite, Viper bite


Snake bite is a widespread and neglected public health problem in tropical and subtropical countries, where rural populations are mainly affected. Although venomous snake bite may lead to a wide range of complications, life-threatening neurological complications such as Intracerebral Haemorrhage (ICH) are rare and infrequently documented in literature. Here we discuss the case of a 64-year-old man who developed ICH following a viper bite, and the neurological sequelae that followed after management.


World Health Organization. Guidelines for the clinical management of snake bites in the South-East Asia Region. 2005:1-67.

Murthy JM, Kishore LT, Naidu KS. Cerebral infarction after envenomation by viper. J Comput Assist Tomogr. 1997;21(1):35-7.

Kumar N, Mukherjee S, Patel MP, Shah KB, Kumar S. A case of saw scale viper snake bite presenting as intraparenchymal haemorrhage: case report. Int J Health Sci Res. 2014;4(10):333-7.

Barlow A, Pook CE, Harrison RA, Wüster W. Coevolution of diet and prey-specific venom activity supports the role of selection in snake venom evolution. Proc Biol Sci. 2009;276(1666):2443-9.

Gouda S, Pandit V, Seshadri S, Valsalan R, Vikas M. Posterior circulation ischemic stroke following Russell’s viper envenomation. Ann Indian Acad Neurol. 2011;14(4):301-3.

Ittyachen AM, Jose MB. Thalamic infarction following a Russell’s viper bite. Southeast Asian J Trop Med Pub Health. 2012;43(5):1201-4.

Menon G, Kongwad L, Nair R, Gowda A. Spontaneous Intracerebral Bleed Post Snake Envenomation. J Clin Diagn Res. 2017;11(4):PD03-4.

Gold BS, Dart RC, Barish RA. Bites of venomous snakes. N Engl J Med. 2002;347(5):347-56.

Cortelazzo A, Guerranti R, Bini L, Hope-Onyekwere N, Muzzi C, Leoncini R. et al. Effects of snake venom proteases on human fibrinogen chains. Blood Transfus. 2010;8(Suppl 3):120-5.

Isbister GK, Duffull SB, Brown SG, ASP Investigators. Failure of antivenom to improve recovery in Australian snakebite coagulopathy. QJM. 2009;102(8):563-8.






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