title: MR findings in neurosyphilis--a literature review with a focus on a practical approach to neuroimaging.
abstract: BACKGROUND
  Syphilis is a sexually transmitted disease caused by Treponema pallium. The invasion of the central nervous system is observed in 5-10% of untreated patients and may occur at any stage of the disease. The diagnosis of the early stage of syphilitic infection is complex as many patients present either nonspecific symptoms or are asymptomatic. The identification of the most common radiologic characteristics of neurosyphilis is important in the proper diagnosis of the infection.
  
  
  METHODS
  The paper reviews the MR findings in neurosyphilis presented in the literature with the emphasis on common traits, patterns and factors in MR neuroimaging in neurosyphilis.
  
  
  RESULTS
  Twelve papers were selected as suitable for analysis. Psychiatric symptomatology was the most common clinical manifestations of neurosyphilis. As MRI findings in neurosyphilis were not highly specific it proved being the most sensitive technique in detecting the changes in cerebral vasculitis commonly presenting with focal areas of high signal intensity in any distribution with areas of infarction and hemorrhage observed at times. In neurosyphilis medium and small vessels are usually involved. Parenchymal and meningeal enhancement was usually demonstrated. The most frequently involved arteries are middle cerebral artery and branches of the basilar artery. However, normal findings were also common.
  
  
  CONCLUSIONS
  The most common MR diagnostic features are medium contrast enhancement, atrophy, white matter lesions, cerebral infarction, oedema. Radiologists, neurologists, and psychiatrists should take neurosyphilis into consideration when facing the differential diagnosis in central vascuclar disorders.
authors.affiliation: First Department of Radiology, Medical University of Gdańsk, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Czarnowska-Cubała
authors.forename: Mariusz S
authors.initials: MS
authors.lastname: Wiglusz
authors.forename: Wiesław Jerzy
authors.initials: WJ
authors.lastname: Cubała
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Jakuszkowiak-Wojten
authors.forename: Jerzy
authors.initials: J
authors.lastname: Landowski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Krysta
mesh_terms: D001921:Brain / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D059906:Neuroimaging / Q000379:methods; D009494:Neurosyphilis / Q000473:pathology*