Grace hospital, Paris
Title: Ischemic stroke following a severe envenomation
I'm a doctor Colonel, Doctor in 1986 at the age of 26 followed by a two-year assignment in an operational area as Doctor captain. After that I did a one-year training in aeronautical medicine in Paris which allowed me to be assigned to the center of expertise for aircrew to the military hospital in Rabat where I prepared the competition assistantship Val de Grâce in anesthesia-reanimation which allowed me to go to PARIS for six years' training to be a specialist in anesthesia resuscitation al hospital of Val de Grace, the hospital Cochin and that to the hospital Lapitié Salpitriere in Paris. In 1998 I was seconded to the Centre Hospitalier de Libreville, Gabon for four years.In 2003 I returned to Morocco to be head of the emergency department at the Military Hospital Moulay Ismail in Meknes. In 2005 I prepared to contest oxyologie aggregation in the Val de Grace hospital in PARIS.In 2009 I was appointed Professor in oxyologie to the Faculty of Medicine and Pharmacy of Rabat and the clinical detaché Royal to become part of the medical staff of Her Majesty. I am also a national expert in the field of viper envenomation.
Objective: Obun ischemic stroke is a rare complication of viper envenomation, probably multifactorial pathophysiological mechanism. We report a observation. Methods: A 55-year victim of a snake bite of the species cerastes cerastes, was admitted to the ICU in an array of multiple organ failure with disseminated intravascular coagulation (DIC), rhabdomyolysis, anuria and elevated troponin. The persistence of impaired consciousness motivated a brain scan which revealed a bifocal stroke (CVA) ischemia. The evolution was favorable in a few weeks after discontinuation of heparin hemodialysis untimely and, despite the initial infusion of antivenom inappropriate (FavAfrique) due to late identification of reptile. Results: A snake bite is rarely complicated cerebral infarction: a series of 309 patients, only eight cerebrovascular complications (2.6%) have been reported, including seven of hemorrhagic and ischemic type one (1). The venom of the species complex C. cerastes procoagulant contains several proteins that produce hypotension, tissue necrosis, kidney damage and coagulopathy DIC type (2). Conclusion : Preventive treatment of complications of envenomation by C. cerastes based on the infusion of antivenom versatile Favirept ®.