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Updated: Aug 5, 2026
06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Syphilis and cerebral stroke: a case report and systematic review
Judith N Wagner1, Matthias Klein2, Susanne Dyckhoff-Shen2
1University Hospital Essen, University Duisburg-Essen, Essen, Germany. judith.wagner@uni-due.de.
Neurological Research and Practice
|August 4, 2026
Summary
Syphilis (Treponema pallidum) is an underrecognized cause of stroke, especially in young men. Early diagnosis and treatment of neurosyphilis are crucial for improving patient outcomes and preventing cerebrovascular events.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Syphilis, caused by Treponema pallidum, is a growing public health concern.
- Neurosyphilis (NS) can manifest as cerebrovascular disease, including ischemic stroke.
- Diagnosing NS is challenging due to varied symptoms and serological difficulties.
Purpose of the Study:
- To report a case of ischemic stroke as the initial presentation of syphilis.
- To conduct a systematic literature review on syphilis-associated stroke.
Main Methods:
- Case report of a 44-year-old HIV-negative male with ischemic stroke.
- Systematic literature search (PubMed, COCHRANE Library) from 1972 onwards.
- Analysis of 98 relevant publications (73 case reports, 36 cohort studies).
Main Results:
- The case patient presented with ischemic stroke attributed to meningovascular syphilis and improved with ceftriaxone.
- Stroke often leads to the diagnosis of syphilis, predominantly in younger males.
- Ischemic stroke, mainly large-vessel disease, is the commonest presentation; penicillin and ceftriaxone are effective treatments.
Conclusions:
- Syphilis is an underrecognized stroke risk factor, particularly in younger individuals.
- Consider neurosyphilis in cryptogenic stroke cases.
- Standardized diagnostic and therapeutic strategies are needed for better recognition and outcomes.
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