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双侧小脑梗死:蝎子蜇伤的一种罕见并发症。

Bilateral cerebellar infarction: a rare complication of scorpion sting.

作者信息

Gadwalkar S R, Bushan S, Pramod K, Gouda Chandra, Kumar P M

机构信息

Department of Medicine, Vijayanagara Institute of Medical Sciences, Bellary.

出版信息

J Assoc Physicians India. 2006 Jul;54:581-3.

Abstract

INTRODUCTION

Complications following scorpion sting are common in India and can be fatal. Stroke following scorpion sting is a rare complication and can occur by various mechanisms such as hypertension, hypotension, DIC, myocarditis and venom-induced vasculitis. We present a rare case of extensive cerebellar infarction following scorpion sting, which has rarely been reported in medical literature.

OBJECTIVES

To study the clinical profile of two patients presenting with an acute onset of cerebellar symptoms following a scorpion sting. To evaluate the possible causes of the stroke and to study the relation of their symptoms to the scorpion sting.

METHODS

Two young women presented with a history of acute onset of dysarthria, ataxia and incoordination following scorpion sting. They did not have any known risk factors for stroke. They had cerebellar type of dysarthria and cerebellar signs on both sides along with incoordination. A CT-scan of the brain showed bilateral extensive cerebellar infarctions. They were investigated for other causes of stroke without any positive results. With treatment the patients made a gradual but complete recovery.

CONCLUSION

Since there was no evidence of hypertension, hypotension, myocarditis or disseminated intravascular coagulation, we can conclude that the patients had suffered a thrombotic stroke caused by the vasculotoxic action of the scorpion venom.

摘要

引言

在印度,蝎子蜇伤后的并发症很常见,且可能致命。蝎子蜇伤后引发的中风是一种罕见的并发症,可通过多种机制发生,如高血压、低血压、弥散性血管内凝血、心肌炎和毒液诱导的血管炎。我们报告一例蝎子蜇伤后发生广泛小脑梗死的罕见病例,医学文献中鲜有报道。

目的

研究两名蝎子蜇伤后急性出现小脑症状患者的临床特征。评估中风的可能原因,并研究其症状与蝎子蜇伤的关系。

方法

两名年轻女性在蝎子蜇伤后出现急性构音障碍、共济失调和不协调的病史。她们没有任何已知的中风危险因素。她们有小脑型构音障碍,双侧小脑体征及不协调。脑部CT扫描显示双侧广泛小脑梗死。对她们进行了其他中风原因的检查,未得到任何阳性结果。经过治疗,患者逐渐完全康复。

结论

由于没有高血压、低血压、心肌炎或弥散性血管内凝血的证据,我们可以得出结论,患者因蝎子毒液的血管毒性作用而发生了血栓性中风。

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