CONCURRENT ISCHEMIC STROKES FROM OCCLUSION OF CAROTID AND VERTEBRAL ARTERIES FOLLOWING A WASP STING IN THE TONGUE

<p style="text-align: justify;">There are no specific risk factors for stroke after bee or wasp stings; however, several researchers have cited multiple stings in the head and neck region as a significant factor in the occurrence of these serious complications. We present a case of a previously healthy man with multiple acute cerebral infarctions in the subcortical and borderline part of the cerebral media artery, resulting from total bilateral thrombosis of the internal carotid artery and right vertebral artery, triggered by a single axial puncture in the tongue, with complete neurological recovery. We present the case of a male, aged 57 years, right- handed, with a history of arterial hypertension, hyperlipoproteinemia, smoking, and a positive family history of cardiovascular disease. He was hospitalized due to speech disorders, left-sided weakness, and altered behaviour. Magnetic resonance imaging of the brain showed multiple infarcts in the border and subcortical area of the cerebral media artery. Computed tomographic angiography of the blood vessels of the head and neck confirmed total bilateral occlusion of the carotid artery of the internal carotid artery and thrombosis of the right vertebral artery. Complete neurological recovery followed during hospitalization. Non-specific clinical picture and neurological findings, characteristic of infarction in border zones, especially bilateral localization, can confuse the emergency physician, and massive thrombosis of blood vessels in the neck may be incorrectly predicted. </p>