Brainstem ischemic stroke after to Bothrops atrox snakebite

• Bothrops atrox envenomation rarely cause cerebral arterial thrombosis.
• Basal and posterior brain arteries are particularly susceptible.
• The endothelial damage is one of the most probable pathogenic mechanisms.

We report case of a 48 years old woman bitten on her right foot by a Bothrops atrox viper. As a result, she developed a severe coagulopathy which improved with application of polyvalent antivenom. Four days after bite she suffered a devastating brainstem ischemic stroke. Possible pathogenetic mechanisms are discussed.