Viper Bite Presenting as Acute Ischemic Stroke

We describe a case of 40 year old female patient who was brought to the hospital with history of altered sensorium, 6 hours, following viper bite. The patient had local envenomation with impaired coagulation and right hemiplegia with motor aphasia. MRI of brain showed infarct in the left middle cerebral artery territory and a normal magnetic resonance angiogram. Neurological manifestations following snake bite is often due to hemorrhagic complications. Presentation with infarction is rare and can be attributed to vasculitis, vasospasm, endothelial damage, toxin induced procoagulant effect and disseminated intravascular coagulation.