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October 1996

Cerebral Infarct After Rattlesnake Bite

Author Affiliations

Cole Neurological Associates 246 S Washington St Casper, WY 82601

Arch Neurol. 1996;53(10):957-958. doi:10.1001/archneur.1996.00550100019005

There are approximately 8000 venomous snakebites and 12 to 15 deaths from snakebites yearly in the United States. However, we found no reference to stroke (nonhemorrhagic or hemorrhagic) temporally related to rattlesnake bites. We report a case following a bite by the prairie rattlesnake (Crotalus viridis viridis).

A 43-year-old white man was admitted to the hospital following 2 generalized convulsions. There was no history of cardiac disease. Two days before these convulsions he was bitten by a prairie rattlesnake (Crotalus viridis viridis). He had Wernicke aphasia, alexia, right inferior quadrantanopia, right central facial weakness, and weakness of his right lower extremity. There were no bruits or any other neurological findings. Laboratory studies revealed the following: an ethanol level of 40.59 mmol/L; hematocrit, 0.59; partial thromboplastin time, 24.1; fibrin split products, more than 40; junctional tachycardia with ST- and T-wave changes; blood pressure, 104/70 mm Hg; and creatine kinase level, 800

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