The value of HR-VWI in the etiological diagnosis of neurosyphilis presented as acute ischemic stroke
10.19845/j.cnki.zfysjjbzz.2022.0274
- VernacularTitle:以急性脑梗死为表现的神经梅毒临床特点及高分辨率磁共振对其病因诊断价值的研究
- Author:
Zhili WANG
1
;
Wei QIN
1
;
Lei YANG
1
Author Information
1. Department of Neurology,Beijing ChaoYang Hospital,Capital Medical University,Beijing 100020,China
- Publication Type:Journal Article
- Keywords:
Neurosyphilis;
Cerebral infarction;
High-resolution magnetic resonance vessel wall imaging;
Atherosclerosis
- From:
Journal of Apoplexy and Nervous Diseases
2022;39(12):1095-1100
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical features of neurosyphilis patients presented as acute cerebral infarction,and to explore the value of high-resolution magnetic resonance vessel wall imaging (HR-VWI ) in the etiological diagnosis of cerebral infarction.Methods Seven patients with neurosyphilis presented as acute ischemic stroke were included in this study from January 2018 to September 2022.The clinical characteristics,laboratory examination,and imaging data including HR-VWI were summarized and analyzed.Results Among seven cases,six patients had multiple atherogenic risk factors,and two tested human immunodeficiency virus (HIV)-seropositive.The most common clinical manifestation was hemiplegia (71.4%),followed by dysarthria (57.1%).Diffusion-weighted magnetic resonance imaging showed high signal lesions more common in the basal ganglia and pons.HR-VWI showed vasculitis changes in infarction-related vessels in six patients,in whom the diagnosis of meningovascular syphilis was considered,while vasculitis change was only shown in one case by MR angiography.Infarct responsible vascular with evidence of atherosclerosis in one case,in whom the diagnosis of large artery atherosclerotic cerebral infarction was considered probable according to the TOAST classification.Conclusion Clinical features of stroke after neurosyphilis can be indistinguishable from ischemic stroke.HR-VWI can reveal vasculitis of meningovascular syphilis,which is of great value in determining the mechanisms of cerebral infarction in neurosyphilis patients who with multiple atherosclerotic risk factors.
- Full text:2024071822135568845The value of HR-VWI in the etiological diagnosis of neurosyphilis presented as acute ischemic stroke.pdf
