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The most serious CNS complications that occur after venomous snakebite are intracranial hemorrhages.1 Ischemic stroke following snakebite is rare and most cases are infarction involving the anterior circulation.2 We present a patient with brainstem infarction following a Korean viper (Agkistrodon blomhoffii brevicaudus) bite.
Case report.
A 54-year-old man was bitten on the right middle finger by a Korean viper. He noted severe pain in the right arm and generalized weakness. Three hours later he felt dizzy, nauseated, began to vomit, and developed diplopia and a right hemiparesis. On admission, his right hand was markedly swollen up to the elbow. He was alert, but had severe swallowing difficulty. There was slight miosis and mild ptosis on the right side, and the right eye was slightly deviated laterally. He had features of one-and-a-half syndrome with peripheral-type left hemifacial palsy and a decreased gag reflex. Right hemiplegia with increased deep tendon reflexes and Babinski sign was present. Emergency care and antivenom polyvalent were given. The patient denied hypertension, diabetes …
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