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Meningovascular syphilis: CT and MR findings
Abstract:
The radiologic findings in three cases of meningovascular syphilis are presented. Angiography demonstrated varying degrees of narrowing and ectasia of the supraclinoid carotid, basilar, and proximal anterior and middle cerebral arteries, as well as distal branches. Computed tomography (CT) showed multifocal infarction with variable enhancement. Similarly, in the one case studied with magnetic resonance (MR), several regions of high signal intensity on T2-weighted sequences were found, which were compatible with foci of ischemia. Although the radiologic findings are nonspecific, the diagnosis of meningovascular syphilis should be considered in patients with vasculitis of uncertain etiology.
Insights
Meningovascular syphilis can cause brain artery narrowing and ectasia, leading to multifocal infarction. Radiologic findings are nonspecific but suggest considering syphilis in vasculitis cases.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Meningovascular syphilis is a rare form of neurosyphilis affecting cerebral blood vessels.
- Early diagnosis and treatment are crucial to prevent neurological damage.
Observation:
- Radiologic imaging (angiography, CT, MR) in three patients revealed characteristic findings.
- Angiography showed arterial narrowing and ectasia in major cerebral arteries.
- CT and MR imaging demonstrated multifocal infarction and ischemic changes.
Findings:
- Imaging findings included narrowing and ectasia of the supraclinoid carotid, basilar, and proximal anterior and middle cerebral arteries.
- Computed tomography (CT) revealed multifocal infarction with variable enhancement.
- Magnetic resonance (MR) showed high signal intensity on T2-weighted sequences, indicative of ischemia.
Implications:
- While radiologic findings are nonspecific, they can suggest meningovascular syphilis.
- Consider syphilis in patients presenting with vasculitis of unknown origin.
- Timely diagnosis based on clinical suspicion and imaging is essential for effective management.