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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Meningovascular syphilis presents as a subacute encephalitic syndrome with superimposed cerebrovascular events that may evolve gradually. This picture differs from the more common cases of thrombotic or embolic stroke. Optimal treatment is uncertain, and requires monitoring of spinal fluid abnormalities until they return to normal.
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PMID:Clinical features of meningovascular syphilis. 653 18

Meningovascular syphilis is now quite uncommon, but there have been increasing reports in patients immunocompromised with human immunodeficiency virus. The response of syphilis affecting the central nervous system to antibiotic therapy remains a challenge. This is an even greater challenge in patients who have underlying compromise of the immune system. The authors present a 46-year-old male with recurrent stroke who was found to have cerebrospinal fluid compatible with syphilitic involvement of the central nervous system and a cerebral arteriogram, which revealed focal narrowing of the right middle cerebral artery. The baseline transcranial Doppler study demonstrated increased mean and peak flow velocity within the right middle cerebral artery. Despite a 10-day course of intravenous penicillin, with substantial improvement in the cerebrospinal fluid results, this flow velocity elevation persisted, in a remarkably consistent pattern, over a 4-month follow-up period. Thus, the involved vessel remained patent following treatment, but no clear resolution of the stenotic lesion was observed.
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PMID:Trancranial Doppler monitoring of response to therapy for meningovascular syphilis. 1259 38

Varicella zoster virus may cause vasculitis or vasculopathy, and positive polymerase chain reactions for varicella zoster virus deoxyribonucleic acid in the cerebrospinal fluid and/or the intrathecal synthesis of antibodies to the varicella zoster virus suggest these diagnoses. Meningovascular syphilis may involve the middle cerebral artery and basilar artery and may cause a stroke. Aspergillus is vasoinvasive and may cause hemorrhagic infarction by forming an intravascular thrombus.
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PMID:[Central nervous system Vasculitis due to infectious diseases]. 2584 41

We describe a case of a 49-year-old man who presented with recurrent strokes in the left middle cerebral artery territory, manifesting with dysphasia, higher cognitive deficits, motor deficits and subsequent infarcts in the right middle cerebral and anterior cerebral artery territories, manifesting with seizures, behavioural and social issues. A key issue of the case was the diagnostic difficulty faced by the physicians. 'Meningovascular syphilis' was subsequently confirmed and appropriate treatment was given but there was subsequent relapse with worsening of the symptoms. Multiple specialists were involved in the management, namely stroke team, neurologists, psychiatrists, infectious disease and multidisciplinary therapy teams. This case highlights the need to be vigilant to the resurgence of syphilis, a scourge from the past, as a cause of stroke, especially in individuals who have had exposure to affected people. It is easy to miss the diagnosis and mistake it for other conditions unless a detailed history is taken and appropriate investigations are conducted, with a low threshold for diagnosis.
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PMID:Meningovascular syphilis causing recurrent stroke and diagnostic difficulties: a scourge from the past. 2988 69