{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:55:37Z","timestamp":1771930537863,"version":"3.50.1"},"reference-count":27,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,11,11]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>A previously healthy middle-aged man in his 40s with a history of red scorpion envenomation presented to the emergency department for the management of an acute stroke syndrome, involving the left middle cerebral artery (MCA) territory, that developed 12 hours after the scorpion sting. He presented to the hospital 15 hours following the stroke. The activation of the autonomic nervous system by the Indian red scorpion venom is known to produce severe systemic manifestations, including cardiogenic shock and acute pulmonary oedema. Death is a rare consequence. Neurological complications resulting from red scorpion injuries are exceedingly uncommon and inadequately documented in the literature. The patient underwent an emergency decompressive craniectomy in view of neurological deterioration despite intracranial pressure-reducing agents. Thrombectomy could not be done in view of the malignant infarct (Alberta Stroke Program Early CT Score of 1) which involved over one-third of the MCA territory. Our patient has made a full recovery and at 6\u2009months\u2019 follow-up; he was capable of walking without assistance. It is essential to promptly identify and manage this under-recognised presentation in order to yield favourable functional outcomes for the patient.<\/jats:p>","DOI":"10.1136\/bcr-2024-260625","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T19:14:34Z","timestamp":1733858074000},"page":"e260625","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Scorpion sting-induced malignant middle cerebral artery infarction"],"prefix":"10.1136","volume":"17","author":[{"given":"Jaya Vigneish","family":"Thangavelu","sequence":"first","affiliation":[{"name":"Critical Care Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1819-8161","authenticated-orcid":false,"given":"Srikanth","family":"Elambilakatt Raroth","sequence":"additional","affiliation":[{"name":"Critical Care Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhanoop","family":"Varghese","sequence":"additional","affiliation":[{"name":"Critical Care Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binila","family":"Chacko","sequence":"additional","affiliation":[{"name":"Critical Care Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"key":"2025082711411944000_17.12.e260625.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1401108"},{"key":"2025082711411944000_17.12.e260625.2","first-page":"959","article-title":"Ischemic Stroke in a Child after a Probable Scorpion Sting","volume":"106","author":"Naranjo","year":"2021","journal-title":"Am J Trop Med Hyg"},{"key":"2025082711411944000_17.12.e260625.3","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1080\/15563650.2021.1884692","article-title":"Epidemiology of scorpionism in France: nationwide scorpion exposure","volume":"59","author":"Vaucel","year":"2021","journal-title":"Clin Toxicol (Phila)"},{"key":"2025082711411944000_17.12.e260625.4","first-page":"581","article-title":"Bilateral cerebellar infarction: a rare complication of scorpion sting","volume":"54","author":"Gadwalkar","year":"2006","journal-title":"J Assoc Physicians India"},{"key":"2025082711411944000_17.12.e260625.5","first-page":"491","article-title":"Myocarditis and multiple cerebral and cerebellar infarction following scorpion sting","volume":"54","author":"Jain","year":"2006","journal-title":"J Assoc Physicians India"},{"key":"2025082711411944000_17.12.e260625.6","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2017-221606","article-title":"Scorpion bite-induced ischaemic stroke","volume":"2017","author":"Reddy C","year":"2017","journal-title":"BMJ Case Rep"},{"key":"2025082711411944000_17.12.e260625.7","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.neurol.2012.10.010","article-title":"AVC isch\u00e9mique suite \u00e0 une morsure de scorpion","volume":"169","author":"Elkhayari","year":"2013","journal-title":"Rev Neurol (Paris)"},{"key":"2025082711411944000_17.12.e260625.8","doi-asserted-by":"crossref","first-page":"155","DOI":"10.4103\/2249-4863.214988","article-title":"Lateral medullary syndrome after a scorpion sting","volume":"6","author":"Thomas","year":"2017","journal-title":"J Family Med Prim Care"},{"key":"2025082711411944000_17.12.e260625.9","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1080\/15563650.2016.1204454","article-title":"Fatal ischemic stroke following Tityus serrulatus scorpion sting in a patient with essential thrombocythemia","volume":"54","author":"Bucaretchi","year":"2016","journal-title":"Clin Toxicol (Phila)"},{"key":"2025082711411944000_17.12.e260625.10","doi-asserted-by":"crossref","first-page":"171","DOI":"10.4103\/jfmpc.jfmpc_808_22","article-title":"Scorpion sting and blindness: A case report","volume":"12","author":"Ravi","year":"2023","journal-title":"J Family Med Prim Care"},{"key":"2025082711411944000_17.12.e260625.11","doi-asserted-by":"crossref","unstructured":"Nagar D . n.d. Extensive ischemic stroke following scorpion sting in a young during hospital stay in a tertiary care hospital: \u2018a rare case report. Int J Sci Res doi:10.36106\/ijsr.","DOI":"10.36106\/ijsr"},{"key":"2025082711411944000_17.12.e260625.12","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5359.25906"},{"key":"2025082711411944000_17.12.e260625.13","doi-asserted-by":"crossref","DOI":"10.1111\/j.1747-4949.2012.00940.x","article-title":"Scorpion Stings: Focus on Cerebrovascular Complications of Envenoming","volume":"8","author":"Brutto","year":"2013","journal-title":"Int J Stroke"},{"key":"2025082711411944000_17.12.e260625.14","doi-asserted-by":"crossref","DOI":"10.1155\/2010\/903295","article-title":"Scorpion venom and the inflammatory response","volume":"2010","author":"Petricevich","year":"2010","journal-title":"Mediators Inflamm"},{"key":"2025082711411944000_17.12.e260625.15","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.idc.2018.10.001","article-title":"Venomous Bites, Stings, and Poisoning: An Update","volume":"33","author":"Warrell","year":"2019","journal-title":"Infect Dis Clin North Am"},{"key":"2025082711411944000_17.12.e260625.16","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1017\/cjn.2018.328","article-title":"Cerebrovascular Injury Following Scorpion Sting and Snake Envenomation: A Case Series","volume":"45","author":"Mishra","year":"2018","journal-title":"Can J Neurol Sci"},{"key":"2025082711411944000_17.12.e260625.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2013.07.012"},{"key":"2025082711411944000_17.12.e260625.18","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-003-1947-0"},{"key":"2025082711411944000_17.12.e260625.19","doi-asserted-by":"publisher","DOI":"10.4103\/0972-5229.40944"},{"key":"2025082711411944000_17.12.e260625.20","unstructured":"International Journal of Scientific Research(IJSR) . Extensive ischemic stroke following scorpion sting in a young during hospital stay in a tertiary care hospital: a rare case report. World Wide Journals. Available: https:\/\/www.worldwidejournals.com\/international-journal-of-scientific-research-(IJSR)\/article\/extensive-ischemic-stroke-following-scorpion-sting-in-a-young-during-hospital-stay-in-a-tertiary-care-hospital-a-rare-case-report\/MTcwNjM=\/?is=1&b1=29&k=8 [Accessed 30 Jun 2024]."},{"key":"2025082711411944000_17.12.e260625.21","doi-asserted-by":"crossref","first-page":"202","DOI":"10.4103\/1755-6783.150114","article-title":"Stroke as a rare consequence of scorpion sting and scorpion ingestion: A case report from South East Nigeria","volume":"7","author":"Eze","year":"2014","journal-title":"Ann Trop Med Public Health"},{"key":"2025082711411944000_17.12.e260625.22","first-page":"100","article-title":"Scorpion bite and multiple cerebral infarcts","volume":"50","author":"Thacker","year":"2002","journal-title":"Neurol India"},{"key":"2025082711411944000_17.12.e260625.23","doi-asserted-by":"crossref","first-page":"331","DOI":"10.3109\/02699059109008104","article-title":"Biopercular lesions and acquired mutism in a young patient","volume":"5","author":"Groswasser","year":"1991","journal-title":"Brain Inj"},{"key":"2025082711411944000_17.12.e260625.24","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/0041-0101(90)90138-W","article-title":"Echocardiographic and radionuclide angiographic observations following scorpion envenomation by Leiurus quinquestriatus","volume":"28","author":"Gueron","year":"1990","journal-title":"Toxicon"},{"key":"2025082711411944000_17.12.e260625.25","first-page":"46","article-title":"Scorpion sting: update","volume":"60","author":"Bawaskar","year":"2012","journal-title":"J Assoc Physicians India"},{"key":"2025082711411944000_17.12.e260625.26","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s13312-015-0626-x","article-title":"Scorpion envenoming,a step ahead","volume":"52","author":"Bawaskar","year":"2015","journal-title":"Indian Pediatr"},{"key":"2025082711411944000_17.12.e260625.27","doi-asserted-by":"crossref","first-page":"188","DOI":"10.15380\/2277-5706.JCSR.15.037","article-title":"Cerebrovascular manifestations following scorpion sting","volume":"5","author":"Nataraja","year":"2016","journal-title":"J Clin Sci Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-260625","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:41:32Z","timestamp":1756320092000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-260625"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":27,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,10]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bcr-2024-260625"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-260625","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}