Department of Neurology, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou City, 215000, Jiangsu Province, People's Republic of China.
Neurol Sci. 2012 Dec;33(6):1411-4. doi: 10.1007/s10072-011-0887-7. Epub 2011 Dec 24.
Syphilis is now rare and easily misdiagnosed because of the wide use of antibiotics in the clinical. We report a case of cerebral hemorrhage in a patient with hypertension who was first diagnosed as hypertensive cerebral hemorrhage. However, treponema pallidum particle agglutination and rapid plasma regain tests of cerebrospinal fluid revealed the existence of neurosyphilis. Interestingly, digital subtraction angiography (DSA) showed severe stenosis in both middle cerebral arteries and right anterior cerebral artery. The case reminded us to pay attention to syphilitic vasculitis in patients with cryptogenic stroke. DSA sometimes may play a critical role in differential diagnosis of neurosyphilis.
梅毒现在很少见，也很容易误诊，因为在临床上抗生素的广泛使用。我们报告了一例高血压患者脑出血的病例，该患者最初被诊断为高血压性脑出血。然而，苍白密螺旋体颗粒凝集和快速血浆再恢复试验脑脊液显示存在神经梅毒。有趣的是，数字减影血管造影（DSA）显示双侧大脑中动脉和右侧大脑前动脉严重狭窄。该病例提醒我们注意隐匿性中风患者的梅毒性血管炎。DSA 有时可能在神经梅毒的鉴别诊断中起关键作用。
