title: The great imitator--still today! A case of meningovascular syphilis affecting the posterior circulation.
abstract: Cerebral ischemia due to meningovascular syphilis is rare and more frequently affects the anterior circulation than the posterior circulation. We describe clinical features and imaging studies of a 50-year-old patient with Parinaud syndrome and a syphilitic dorsal midbrain infarction. Brain magnetic resonance imaging indicated vasculitis of the posterior circulation. The diagnosis of meningovascular syphilis was established by serum and cerebrospinal fluid examinations. Although rare, because of the high impact on treatment, clinicians should always be aware of meningovascular syphilis in the differential diagnosis of stroke, particularly in young and male patients with cryptogenic stroke.
authors.affiliation: Department of Neurology, University Hospital Freiburg, Freiburg, Germany. Electronic address: jochen.baeuerle@uniklinik-freiburg.de.
authors.forename: Jochen
authors.initials: J
authors.lastname: Bäuerle
authors.affiliation: Department of Neurology, University Hospital Freiburg, Freiburg, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Zitzmann
authors.affiliation: Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Egger
authors.affiliation: Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Meckel
authors.affiliation: Department of Neurology, University Hospital Freiburg, Freiburg, Germany.
authors.forename: Cornelius
authors.initials: C
authors.lastname: Weiller
authors.affiliation: Department of Neurology, University Hospital Freiburg, Freiburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Harloff
mesh_terms: D020526:Brain Stem Infarctions / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology*; D008875:Middle Aged; D009494:Neurosyphilis / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000473:pathology; D015835:Ocular Motility Disorders / Q000175:diagnosis* / Q000473:pathology; D020521:Stroke / Q000175:diagnosis* / Q000473:pathology
keywords: MRI; Meningovascular syphilis; stroke; vasculitis