Touré M L, Baldé T H, Diallo M S, Othon G Carlos, Camara N, Barry S D, Konaté M M, Sakadi F, Lamah E, Diallo B, Diakité M, Sakho A, Camara D, Condé S, Madandi H, Millimono V, Barry A K T, Diallo M T, Traoré N, Kassa F D, Koné A, Souaré I S, Kadji J M, Diallo M H, Tounkara A, Rafkat S A, Diallo T M, Mara J F, Cissé F A, Cissé A
Department of Neurology, CHU of Conakry, Guinea.
Department of Radiology, Conakry University Hospital, Guinea.
eNeurologicalSci. 2023 Jun 14;32:100470. doi: 10.1016/j.ensci.2023.100470. eCollection 2023 Sep.
In sub-Saharan Africa (SSA), stroke is a major public health problem and the etiological aspects are poorly studied and documented because of under-medicalization; the syphilitic etiology is rarely mentioned.
We performed a retrospective study of 472 patients hospitalized for ischemic stroke between 2016 and 2021 in the Neurology Department of the University Hospital of Conakry, confirmed by neuroradiological explorations (brain CT, MRI-Angio) and a biological workup including VDRL-TPHA serological reactions in blood and CSF.
Syphilitic etiology was retained for six (6) patients (4 men and 2 women) with a mean age of 43 years (extremes 36 and 49 years). The clinical picture was dominated by carotid syndromes: superficial and deep sylvian syndrome, anterior cerebral artery syndrome and vertebro-basilar syndromes and one case of lacunar syndrome.The diagnosis was based on the positivity of serological reactions (VDRL-TPHA) in blood and cerebrospinal fluid (CSF) and the presence of a predominantly lymphocytic hypercellularity and a hyperproteinorachy in the CSF in the absence of any other etiology.
These neurological vascular syndromes consecutive to a cerebral treponematous attack are often the result of a still poorly conducted management of primary and secondary syphilis in our country.
在撒哈拉以南非洲地区（SSA），中风是一个重大的公共卫生问题，由于医疗资源不足，其病因方面的研究和记录很少；梅毒病因很少被提及。
我们对2016年至2021年间在科纳克里大学医院神经科住院的472例缺血性中风患者进行了回顾性研究，这些患者经神经放射学检查（脑部CT、MRI血管造影）及包括血液和脑脊液中的VDRL - TPHA血清学反应在内的生物学检查得以确诊。
6例（4男2女）患者被认定为梅毒病因，平均年龄43岁（范围36至49岁）。临床表现以颈动脉综合征为主：浅部和深部大脑外侧裂综合征、大脑前动脉综合征和椎基底动脉综合征，还有1例腔隙综合征。诊断依据是血液和脑脊液（CSF）中血清学反应（VDRL - TPHA）呈阳性，以及在没有任何其他病因的情况下，脑脊液中主要为淋巴细胞增多和蛋白含量增高。
这些继发于脑梅毒感染的神经血管综合征往往是我国一期和二期梅毒治疗仍不完善的结果。
