Basal ganglia hemorrhage secondary to scorpion sting: a fatal presentation

Abstract

Introduction: Cerebrovascular manifestations are uncommon presentations of scorpion sting in the Indian subcontinent. Encephalopathy, cerebral edema, subarachnoid hemorrhage, non-hemorrhagic strokes, and cortical necrosis are a few CNS complications described in the medical literature due to scorpion envenomation. Case description: We report a rare case of scorpion envenomation in a 40-year old, non-hypertensive farmer, who presented in an unconscious state. Non-contrast CT head revealed intracerebral hemorrhages in left temporoparietal lobe extending into left basal ganglia with intraventricular extension. Discussion and evaluation: Toxin-induced autonomic storm is mostly responsible for the acute hypertensive crisis in affected individuals leading to stroke (commonly cerebral infarct) as a CNS complication. Conclusion: Basal ganglia bleed following scorpion sting is an extremely rare scenario which is usually fatal as was in our case. Early suspicion and prompt institution of treatment (prazosin) is crucial in the management of intracranial bleed secondary to scorpion sting.