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Paraparesis due to syphilitic aortic dissection
M W Kellett1, G R Young, N A Fletcher
1Walton Centre, Liverpool, England.
Neurology
|January 1, 1997
Summary
This case report details a patient with acute spinal cord infarct, leading to paraparesis and pain. Investigations uncovered a dissecting thoracic aortic aneurysm and syphilis, suggesting a link between these conditions.
Area of Science:
- Neurology
- Cardiology
- Infectious Diseases
Background:
- Spinal cord infarcts can present with varied neurological deficits.
- Aortic aneurysms pose significant cardiovascular risks.
- Tertiary syphilis can manifest in diverse clinical forms, including cardiovascular involvement.
Observation:
- A patient presented with acute paraparesis and segmental pain, indicative of spinal cord ischemia.
- Neurological examination revealed no sensory or sphincter dysfunction.
- Imaging demonstrated an extensive dissecting thoracic aortic aneurysm.
Findings:
- Positive treponemal serologic findings confirmed syphilis.
- The clinical presentation and investigations suggest a correlation between the dissecting aortic aneurysm, tertiary syphilis, and the spinal cord infarct.
Implications:
- This case highlights the importance of considering syphilis in the differential diagnosis of spinal cord infarcts, especially in the presence of aortic pathology.
- Early diagnosis and treatment of cardiovascular syphilis are crucial to prevent severe complications.
- Further research may elucidate the specific mechanisms linking aortic dissection, syphilis, and ischemic events in the spinal cord.