Feng Wuwei, Caplan Michael, Matheus Maria G, Papamitsakis Nikolaos I H
Department of Neurosciences, 96 Jonathan Lucas Street, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Am J Med Sci. 2009 Aug;338(2):169-71. doi: 10.1097/MAJ.0b013e3181a40b81.
We report the case of a young patient with meningovascular syphilis who suffered fatal vertebrobasilar occlusion despite thrombolytic treatment and endovascular interventions. A 35-year-old man without any known medical history presented with an acute ischemic stroke and was initially treated with intravenous tissue plasminogen activator. He was then transferred to the stroke center, where he underwent endovascular recanalization of his occluded vertebrobasilar system. Despite initial successful recanalization, he suffered recurrent vertebrobasilar occlusion, and a second endovascular treatment attempt was unsuccessful. He subsequently developed a pontine hemorrhage and acute hydrocephalus and died secondary to transtentorial herniation. Laboratory findings were suggestive of prior spirochetal infection, and autopsy revealed necrotizing vasculitis and extensive adventitial inflammation involving the basilar and vertebral arteries, supporting the diagnosis of meningovascular syphilis.
我们报告了一例年轻的脑膜血管梅毒患者，尽管接受了溶栓治疗和血管内介入治疗，但仍发生了致命的椎基底动脉闭塞。一名35岁无任何已知病史的男性出现急性缺血性中风，最初接受了静脉注射组织纤溶酶原激活剂治疗。随后他被转至卒中中心，在那里对其闭塞的椎基底动脉系统进行了血管内再通治疗。尽管最初成功实现了再通，但他仍发生了复发性椎基底动脉闭塞，第二次血管内治疗尝试未成功。他随后出现脑桥出血和急性脑积水，并因小脑幕切迹疝而死亡。实验室检查结果提示既往有螺旋体感染，尸检显示坏死性血管炎以及累及基底动脉和椎动脉的广泛外膜炎症，支持脑膜血管梅毒的诊断。
