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A Singular Case of Neurosyphilis Manifesting Through a Meningovascular Chronic Inflammatory Process in Association with the Occurrence of Two Aneurysms Involving the Distal A2 Segment of Both Anterior Cerebral Arteries: A Case Report and Review of the Literature.
World Neurosurg. 2016 Mar; 87:662.e13-8.WN

Abstract

BACKGROUND

Although syphilis has become a rare disease in the Western world since the Second World War, it is believed to have infected 12 million people in 1999, with greater than 90% of cases occurring in the developing world. Moreover, since the year 2000, the rates of syphilis have been increasing in the United States, the United Kingdom, Australia, and Europe. Because of the mimic nature of the disease and the overall low rate of occurrence of its manifestations in advanced stages, a proper diagnosis may prove difficult.

CASE REPORT

We report the case of a 41-year-old African man affected by neurosyphilis that manifested itself through a meningovascular chronic inflammatory process, with the peculiar feature of a bilateral aneurysm of probable mycotic origin involving the distal tract of A2 segment of both anterior cerebral arteries.

CONCLUSIONS

Because of the mostly nonspecific nature of clinical manifestations of syphilis (particularly advanced syphilis) and its consequent tendency to masquerade as many other diseases, even a skilled physician may find its diagnosis quite challenging; thus, thorough clinical and radiologic investigations should be supported by serologic testing for syphilis in all cases of cognitive impairment. Mycotic intracranial aneurysms in association with neurosyphilis rarely are reported; however, they require early diagnosis and meticulous, individualized treatment. Because syphilis appears to be on the raise, further studies on the topic are warranted.

Authors+Show Affiliations

Department of Neurosurgery III, Foundation of the "Carlo Besta" Neurological Institute, IRCCS, Milan, Lombardy, Italy. Electronic address: davide.bagatti@libero.it.Department of Neuropathology, Foundation of the "Carlo Besta" Neurological Institute, IRCCS, Milan, Lombardy, Italy.Department of Neurosurgery III, Foundation of the "Carlo Besta" Neurological Institute, IRCCS, Milan, Lombardy, Italy.Department of Neurosurgery III, Foundation of the "Carlo Besta" Neurological Institute, IRCCS, Milan, Lombardy, Italy.Department of Neurosurgery III, Foundation of the "Carlo Besta" Neurological Institute, IRCCS, Milan, Lombardy, Italy.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26548820

Citation

Bagatti, Davide, et al. "A Singular Case of Neurosyphilis Manifesting Through a Meningovascular Chronic Inflammatory Process in Association With the Occurrence of Two Aneurysms Involving the Distal A2 Segment of Both Anterior Cerebral Arteries: a Case Report and Review of the Literature." World Neurosurgery, vol. 87, 2016, pp. 662.e13-8.
Bagatti D, Mazibrada J, Ligarotti GK, et al. A Singular Case of Neurosyphilis Manifesting Through a Meningovascular Chronic Inflammatory Process in Association with the Occurrence of Two Aneurysms Involving the Distal A2 Segment of Both Anterior Cerebral Arteries: A Case Report and Review of the Literature. World Neurosurg. 2016;87:662.e13-8.
Bagatti, D., Mazibrada, J., Ligarotti, G. K., Nazzi, V., & Franzini, A. (2016). A Singular Case of Neurosyphilis Manifesting Through a Meningovascular Chronic Inflammatory Process in Association with the Occurrence of Two Aneurysms Involving the Distal A2 Segment of Both Anterior Cerebral Arteries: A Case Report and Review of the Literature. World Neurosurgery, 87, e13-8. https://doi.org/10.1016/j.wneu.2015.10.085
Bagatti D, et al. A Singular Case of Neurosyphilis Manifesting Through a Meningovascular Chronic Inflammatory Process in Association With the Occurrence of Two Aneurysms Involving the Distal A2 Segment of Both Anterior Cerebral Arteries: a Case Report and Review of the Literature. World Neurosurg. 2016;87:662.e13-8. PubMed PMID: 26548820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Singular Case of Neurosyphilis Manifesting Through a Meningovascular Chronic Inflammatory Process in Association with the Occurrence of Two Aneurysms Involving the Distal A2 Segment of Both Anterior Cerebral Arteries: A Case Report and Review of the Literature. AU - Bagatti,Davide, AU - Mazibrada,Jasenka, AU - Ligarotti,Gianfranco Kim Innocente, AU - Nazzi,Vittoria, AU - Franzini,Angelo, Y1 - 2015/11/05/ PY - 2015/08/11/received PY - 2015/10/23/revised PY - 2015/10/24/accepted PY - 2015/11/10/entrez PY - 2015/11/10/pubmed PY - 2016/7/29/medline KW - Anterior cerebral artery KW - Biopsy KW - Meningovascular inflammation KW - Mycotic aneurysm KW - Neurosyphilis KW - Serological scar SP - 662.e13 EP - 8 JF - World neurosurgery JO - World Neurosurg VL - 87 N2 - BACKGROUND: Although syphilis has become a rare disease in the Western world since the Second World War, it is believed to have infected 12 million people in 1999, with greater than 90% of cases occurring in the developing world. Moreover, since the year 2000, the rates of syphilis have been increasing in the United States, the United Kingdom, Australia, and Europe. Because of the mimic nature of the disease and the overall low rate of occurrence of its manifestations in advanced stages, a proper diagnosis may prove difficult. CASE REPORT: We report the case of a 41-year-old African man affected by neurosyphilis that manifested itself through a meningovascular chronic inflammatory process, with the peculiar feature of a bilateral aneurysm of probable mycotic origin involving the distal tract of A2 segment of both anterior cerebral arteries. CONCLUSIONS: Because of the mostly nonspecific nature of clinical manifestations of syphilis (particularly advanced syphilis) and its consequent tendency to masquerade as many other diseases, even a skilled physician may find its diagnosis quite challenging; thus, thorough clinical and radiologic investigations should be supported by serologic testing for syphilis in all cases of cognitive impairment. Mycotic intracranial aneurysms in association with neurosyphilis rarely are reported; however, they require early diagnosis and meticulous, individualized treatment. Because syphilis appears to be on the raise, further studies on the topic are warranted. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/26548820/A_Singular_Case_of_Neurosyphilis_Manifesting_Through_a_Meningovascular_Chronic_Inflammatory_Process_in_Association_with_the_Occurrence_of_Two_Aneurysms_Involving_the_Distal_A2_Segment_of_Both_Anterior_Cerebral_Arteries:_A_Case_Report_and_Review_of_the_Literature_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(15)01503-X DB - PRIME DP - Unbound Medicine ER -