[Meningovascular syphilis: study of five cases].Rev Neurol (Paris). 2008 Apr; 164(4):369-73.RN
Clinical manifestations of syphilis are highly variable, and currently on the rise. We report five cases of ischemic stroke related to neurosyphilis.
The cases of five men aged 37, 34, 41, 42 and 44 years are reported. A notion of a genital chancre was noted in three. The clinical presentation was typical of ischemic stroke in four patients. One presented with intellectual deterioration. Imaging revealed zones of ischemia in all five patients. Examination of the cerebrospinal fluid revealed lymphocytic meningitis and all five patients exhibited positive syphilis serology. Brain angiography demonstrated signs of arthritis in four patients and carotid dissection in one. Improvement was achieved with penicillin G in four patients.
When the cause is doubtful, the routine work-up for ischemic stroke in young subjects should include syphilis serology.