A case series of posterior circulation ischaemic stroke following viper snake bite

Snakebite is a common problem in Rural India. Viper snake bite is India's most common cause of fatal snake bites. They are usually associated with hemorrhagic complications. Ischemic complications following viper bite are uncommon and have only been reported by a few authors. A posterior circulation stroke is even rarer as it is challenging to diagnose. It is also fatal if there is a delay in diagnosis. We report a series of 5 patients with posterior circulation infarcts following viper envenomation confirmed by MRI Brain. We review published literature and discuss the likely pathogenesis of the ischaemic stroke following a viper bite. This study stresses the need for a higher degree of suspicion for posterior circulation stroke following snakebite and an early radiological diagnosis. Following diagnosis, adequate hydration, maintaining blood pressure, antiplatelets, and ICP lowering measures are essential. Snakebite should be considered a differential diagnosis in a young patient with stroke, especially in rural areas.