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• Vol.63 No.9
• CLINICA NEUROL, 63: 588−591, 2023
• Vol.63 No.9 contents

Case Report

Changes in vessel wall magnetic resonance contrast-enhancement in a patient with multiple cerebral infarction due to meningovascular neurosyphilis

Hitoshi Miyatake, M.D.¹⁾, Takuya Oguri, M.D., Ph.D.¹⁾, Keita Sakurai, M.D., Ph.D.²⁾, Yoshikazu Mutoh, M.D., D.T.M.&H.³⁾, Hideki Kato, M.D., Ph.D.¹⁾ and Hiroyuki Yuasa, M.D., Ph.D.¹⁾

¹⁾ Department of Neurology, Tosei General Hospital
²⁾ Department of Radiology, National Center for Geriatrics and Gerontology
³⁾ Department of Infectious Diseases, Tosei General Hospital

A 46-year-old man with a history of generalized skin rash following physical contact with possible syphilis infection developed right upper and lower extremity ataxia and right lower extremity paresis. Brain magnetic resonance (MR) imaging revealed multiple areas of acute cerebral infarction mainly within the territories of the right superior cerebellar artery (SCA) and left anterior cerebral artery. The patient was diagnosed with meningovascular neurosyphilis based on positive results on syphilis testing of the serum and cerebrospinal fluid. MR angiography revealed decreased signal intensity in the proximal segment of the right SCA, and gadolinium-enhanced three-dimensional T₁-weighted MR images showed an enhancement of the vessel wall in this segment of the artery. Signal intensity in the right SCA showed partial improvement following the completion of intravenous penicillin treatment, and contrast enhancement of the vessel wall disappeared simultaneously with clinical improvement. Alterations in cerebral vessel walls on contrast-enhanced MR imaging in cases of meningovascular neurosyphilis may reflect vascular inflammatory activity.
Full Text of this Article in Japanese PDF (1117K)

(CLINICA NEUROL, 63: 588−591, 2023)
key words: neurosyphilis, vasculitis, gadolinium-enhanced three-dimensional T₁-weighted MR images, MR angiography

(Received: 22-Jun-23)