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Background and Aims: Post-stroke complications can lead to frequent and major causes of death in the early phases after an acute stroke. Aims of the present study were to determine the association of several risk factors with the occurrence of poststroke complications, the predictors for the development of complications, and to evaluate how these complications affected the overall prognosis among subjects with the first ever acute stroke. This study is the pioneer study of this kind from Eastern India. Previous national and international studies on this lack uniformity in their results probably because of the following reasons: no standard definitions for complications following the stroke, varied follow-up periods ranging from 1 week to 30 months, type and severity of stroke affecting the incidence, and finally, the demographic variables. Methods: This was an observational, prospective study, in which a total of 521 adult male and female patients who had a first-ever acute stroke, aged between 12 years to 75 years were enrolled over a period of 2 years (September 2016 to September 2018), admitted in Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, India. Patients with first ever acute stroke were studied for post-stroke complications (predefined with standard criteria) during the hospital stay at Bangur Institute of Neurosciences (BIN), Kolkata, India, and their association with risk factors, severity of stroke (National Institutes of Health Stroke Scale Score, NIHSS), length of hospital stay (in days) and outcome (Modified Rankin Scale, MRS) were assessed. Results: A total of screened 498 patients who were admitted at Bangur Institute of Neurosciences (BIN), Kolkata, India, with first ever acute stroke were recruited. The mean age was 61.02 years (range 23-75 years), the majority being male (n = 307; 61.6%). Post-stroke complication during hospital stay was documented in 270 patients (54.2%) (males and females combined). In logistic regression analysis, multiple risk factors (OR, 1.571; 95% CI, 1.084-2.278; P-0.017), severity of stroke (National Institutes of Health Stroke Scale Score, NIHSS) (OR, 1.425; 95% CI, 1.027-1.976; P-0.034) and length of hospital stay (in days) (OR, 3.565; 95% CI, 2.029-6.264; P < 0.0001) were the most robust predictors of occurrence of complications. The independent predictors of poor outcome in subjects with complications were: chest infection (OR, 2.07; 95% CI, 1.006-4.26; P = 0.048), bedsores (OR, 2.26; 95% CI, 1.03-4.94; P-0.042), and seizures (OR, 5.072; 95% CI, 1.08-23.79; P-0.039). Conclusion: In our study, the most independent predictors of complications were severity of stroke and length of hospital stay. This observation might help clinicians in taking appropriate measures towards preventing post-stroke complications and thereby improving outcome following a stroke. [ABSTRACT FROM AUTHOR]

Owing to the antihemostatic property of viper venom, hemorrhagic complications including intracerebral hemorrhage are the most commonly encountered after viper bite. Ischemic strokes have been rarely reported after viper envenomation, and its occurrence has been attributed to multiple mechanisms. Postsnakebite seizures are known to occur after neurotoxic bite. Here, we report the case of a viper bite victim who developed status epilepticus within 3 h after viper bite. He had only mild signs of local envenomation, and prolonged whole blood clotting time was the only manifestation of systemic envenomation. Subsequently, he was found to have developed right hemiparesis and global aphasia. Brain imaging revealed large infarcts in bilateral middle cerebral artery (MCA) territories. We report this as a unique case of viper bite which presented to the emergency room with status epilepticus. Moreover, bilateral MCA infarct, as was found in this case, is genuinely rare in scientific literature. Finally, the absence of overt features of envenomation makes this case stand out from other similar reported occurrences., Competing Interests: None