We here present a case of a 40 year old man with Daboia russelli siamensis snakebite .Patient presented to the hospital because of oliguria and weakness of left foot .Upon cranial computed tomography (CT ) examination ,a right frontal , temporal ,parietal lobe and left parietal lobe subdural hematoma was revealed .Patient was then monitored and after 10 days ,cra‐nial CT showed right frontal ,temporal and parietal lobe subdural hematoma increased in size with possibility of surrounding hemorrhagic brain infarction and brain hernia .This is a unique case in which we present cranial hemorrhage and infarction in the same patient following snakebite and make a brief review of literature of related cases .%圆斑蝰蛇（Daboia russelii siamensis ），又称百步金钱豹、卢氏蝰蛇、锁蛇，为蛇亚目蝰蛇科蝰亚科山蝰属的一种血循毒毒蛇，为我国南方常见毒蛇之一，主要集中于广西、广东、台湾等人口稠密地区，亦分布在缅甸、泰国、柬埔寨、印度尼西亚等地。圆斑蝰蛇活跃于平原或丘陵地带，具有高攻击性，其在攻击时常采用突袭，所以患者被咬伤时多在毫无心理准备的的情况下发生。因此，圆斑蝰蛇咬伤的记录和报道居高不下。在上述地区，平均每年毒蛇咬伤发病率高达5‰，超过20000人因此死亡。根据文献报道，相比脑梗死患者，圆斑蝰蛇咬伤患者更易出现颅内出血症状。本文首次报告圆斑蝰蛇咬伤致脑出血后出血性脑梗死1例。
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