Meningovascular neurosyphilis as the cause of ischemic cerebrovascular disease in a young man

摘要: Authors report a case of 35-year-old male with right-sided mild paresis, incontinence, dysexecutive syndrome, short-term memory loss and behavioral changes. Bilateral cerebral infarcts in the region caudate nuclei adjacent white matter were proved by brain MRI multiple stenoses branches Willis-circle confirmed MR angiography. Elevated protein level pleocytosis found cerebrospinal fluid intrathecal IgG synthesis. Serum rapid plasma reagin, Treponema pallidum Particle Agglutination test, ELISA, liquor Venereal Disease Research Laboratory tests positive. Meningovascular neurosyphilis was diagnosed. 24M U/day intravenous penicillin-G treatment given for 14 days. The patient has vascular dementia due to bilateral strategic disconnecting prefrontal circuits; his symptoms are similar general paresis. radiologic improvement observed. Still, have severe residual cognitive decline.