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Neurosyphilis presenting with a large vessel occlusion: A case report
Neeharika Krothapalli1, Ninad Desai2, Ajay Tunguturi3
1Department of Neurology, UCONN School of Medicine, Connecticut, USA.
Brain Circulation
|January 24, 2022
Summary
Neurosyphilis can cause stroke in young adults, presenting diagnostic challenges. Early identification and multidisciplinary management, including mechanical thrombectomy, are crucial for successful outcomes in meningovascular syphilis.
Area of Science:
- Neurology
- Infectious Diseases
- Vascular Neurology
Background:
- Stroke in young individuals necessitates a broad differential diagnosis.
- Neurosyphilis is an uncommon but critical cause of cerebrovascular events.
- Meningovascular syphilis can lead to arterial occlusion and ischemic stroke.
Observation:
- A 36-year-old male presented with stroke symptoms including headache, slurred speech, and left-sided weakness.
- The stroke occurred in the right paramedian pons, a pontine perforator territory.
- Diagnostic challenges were encountered in identifying neurosyphilis as the underlying cause.
Findings:
- The patient was diagnosed with meningovascular syphilis causing basilar artery thrombosis.
- A multidisciplinary team involving neurology, infectious diseases, and neurointervention managed the case.
- Successful treatment involved mechanical thrombectomy for the arterial occlusion.
Implications:
- This case underscores the importance of considering neurosyphilis in young stroke patients.
- Vigilance for risk factors and thorough investigation are key for diagnosing neurosyphilis.
- Prompt diagnosis and integrated management, including endovascular therapy, can improve stroke outcomes.
