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Neurology. Neuropathology. Nervous system (985) |
Psychiatry. Pathological psychiatry. Psychopathology. Phrenopathies. Psychoses. Mental abnormality. Morbid mental states. Behavioural and emotional disturbances (292) |
SM ISO690:2012 VASILIEVA, Maria, FRIMU, Anastasia, CUCUSCIUC, Cristina, ZOTA, Eremei, CRIVORUCICA, Igor, GROPPA, Stanislav. Case report: neurosyphilis imitator of acute ischemic stroke. In: Revista de Ştiinţe ale Sănătăţii din Moldova, 2022, nr. 3 An.1(29), p. 273. ISSN 2345-1467. |
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Revista de Ştiinţe ale Sănătăţii din Moldova | ||||||
Numărul 3 An.1(29) / 2022 / ISSN 2345-1467 | ||||||
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CZU: 616.8-002.6+616.89-008.45 | ||||||
Pag. 273-273 | ||||||
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Background: 40% of patients with syphilis can be affected by the spirochetal invasion of the central nervous system. Neurosyphilis can be presented with stroke signs in 14,09% of patients, and the misdiagnosis rate in such cases can reach up to 80,95%. Objective: Presentation of a diagnostic pathway in case of suspected stroke due to neurosyphilis, with an evaluation of the clinic-imagistic correlation. Materials and methods: A case of a 74-year-old patient with ischemic stroke due to meningovascular syphilis will be reported. Correlate our case with literature data as well. Analysis of it was performed, using the keywords: „neurosyphilis”, „ischemic stroke”, and „neuroimaging” from the PubMed database search. Results: The patient was admitted to the hospital, with sudden onset of speech disturbances, right-side hemiparesis, and neck rigidity. Brain MRI revealed ischemic involvement of fronto-parieto-temporal and insular cortex, periventricular leukoaraiosis, ventricular dilatation, multiple encefalomacies, and leptomeningeal enhancement. According to literature, neuroimaging features of neurosyphilis include ischemic stroke, cerebral atrophy, ventricular dilatation, mesial temporal, frontal, parietal, and insular cortex involvement. Serologic tests for syphilis confirm our suspicions with RPR 4+1:2 and TPHA 4+. Patient was referred, to specialized treatment. Conclusions: Neurosyphilis can mimic acute ischemic stroke, presented by similar clinical signs and neuroimaging findings; the serological tests are crucial for diagnosis. Because therapeutic approaches differ in case of neurosyphilis, DD is very important. |
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Cuvinte-cheie neurosyphilis, ischemic stroke, neuroimaging, Neurosifilisul, accidentul vascular cerebral ischemic, neuroimagistica |
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