Neurológia pre prax 1/2022

Neurosyphilis as a cause of ischaemic stroke

Syphilis is a chronic systemic disease which is manifested by a wide range of signs and symptoms, particularly in the sex organs, but it also affects the cardiovascular, nervous, integumentary, or musculoskeletal systems. An involvement of the central nervous system may occur at any point of the primary, secondary, or tertiary stages of syphilis. Early forms of neurosyphilis currently prevail, with late parenchymal complications occurring rarely. Meningovascular syphilis typically presents five to seven years after the primary stage, and is among the rare causes of cerebrovascular disease in younger individuals. Imaging of the brain and cerebral arteries as well as a comprehensive cerebrospinal fluid analysis are of crucial importance for the diagnosis. Benzylpenicillin is the principal drug. A case report is presented of a 52-year-old man with neurosyphilis manifested by acute ischaemic stroke in the vertebrobasilar territory in the setting of basilar artery occlusion.

Keywords: neurosyphilis, meningovascular syphilis, ischaemic stroke, basilar artery occlusion