Related Experiment Video
Updated: Jul 8, 2026
08:36
A Versatile Murine Model of Subcortical White Matter Stroke for the Study of Axonal Degeneration and White Matter Neurobiology
Published on: March 17, 2016
8.0K
Neurosyphilis with stroke-like manifestations: A case report
Ling Zeng1, Bin Wu, Yushi Zhong
1Department of Neurology, Hunan University of Medicine General Hospital, Huaihua, PR China.
Medicine
|April 28, 2025
Summary
This case highlights a rare instance of neurosyphilis presenting with stroke-like symptoms but negative diffusion-weighted imaging (DWI) on MRI. Prompt penicillin treatment led to significant recovery, emphasizing the need for vigilance against misdiagnosis.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Neurosyphilis commonly presents with stroke-like episodes, often visualized as ischemic lesions on MRI.
- This report details an unusual case of neurosyphilis exhibiting stroke-like episodes without diffusion-weighted imaging (DWI) abnormalities.
Purpose of the Study:
- To report a unique case of neurosyphilis with stroke-like symptoms and DWI-negative MRI findings.
- To underscore the importance of considering neurosyphilis in stroke-like presentations, even with atypical imaging results.
Main Methods:
- A patient presented with progressive left limb weakness.
- Initial CT and MRI scans revealed diffuse brain lesions, but no clear signs of cerebral infarction; DWI was negative.
- Serological tests for syphilis were positive in both serum and cerebrospinal fluid.
Main Results:
- The patient experienced worsening limb weakness before treatment.
- Intravenous penicillin G administration led to gradual and complete normalization of muscle strength within 10 days.
- A 6-month follow-up indicated a good overall recovery.
Conclusions:
- Neurosyphilis can manifest with stroke-like episodes, sometimes without typical ischemic MRI findings.
- The case emphasizes the potential for diffuse brain imaging changes in neurosyphilis beyond infarction.
- Clinical suspicion and appropriate serological testing are crucial to avoid misdiagnosis in such presentations.
Related Concept Videos
01:29Stroke: Introduction and Types
A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:19Multiple Sclerosis l: Introduction
Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...