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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Fatal cerebellar hemorrhage following Australian brown snake envenomation.
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Fatal cerebellar hemorrhage following Australian brown snake envenomation.

机译：澳大利亚棕蛇毒化后发生致命性小脑出血。

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摘要

Venomous snakebites cause significant global morbidity and mortality, but their sequela are rarely encountered in neuropathology practice in North America. This case illustrates the potential dire consequences of a bite from one of the world's most venomous snakes, the Australian brown snake.A 69-year-old female with a past medical history of hypertension stepped on an Australian brown snake outside of her home in Western Australia and was bitten on the instep of her foot. Appropriate pressure-immobilization first aid was initiated and the Emergency room assessment within 15 minutes of the bite revealed an INR of 0.9 and a baseline Creatinine of 191. Thirty minutes after the bite she began feeling unwell, vomited, started bleeding from her IV site, and her INR was 10. Brown snake venom was detected in her urine and she was treated with 5 Units of Brown snake anti-venom. Over the course of the next 48 hours her coagulopathy worsened (INR > 30), she was persistently hypertensive (up to 235/150 despite medical management), and she developed microangiopathic hemolytic anemia and renal failure (maximum Creatinine of 303). When her level of consciousness deteriorated a computed tomography (CT) scan showed an intraparenchymal hemorrhage in the posterior fossa (Figure 1). She died within 48 hours of being bitten.
机译：毒蛇咬伤会导致严重的全球发病率和死亡率，但在北美的神经病理学实践中很少见到它们的后遗症。该病例说明了被世界上最毒的蛇之一澳大利亚棕蛇咬伤的潜在可怕后果。一名69岁的女性，曾有高血压病史，曾在西部西部的家中踩踏澳大利亚棕蛇澳大利亚，脚背被咬伤。开始适当的压力固定急救措施，在被咬后15分钟内进行急诊室评估，发现INR为0.9，基线肌酐为191。被咬后30分钟，她开始感到不适，呕吐，从IV部位开始流血， INR为10。尿液中检出棕蛇毒，并用5个单位的棕蛇抗蛇毒治疗。在接下来的48小时内，她的凝血病恶化（INR> 30），她持续高血压（尽管进行了药物治疗，但仍高达235/150），并且发展为微血管性溶血性贫血和肾衰竭（最大肌酐为303）。当她的意识水平下降时，计算机断层扫描（CT）扫描显示后颅窝实质内出血（图1）。她被咬后48小时内死亡。

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