Conference paper
MR FINDINGS IN NEUROSYPHILIS – A LITERATURE REVIEW WITH A FOCUS ON A PRACTICAL APPROACH TO NEUROIMAGING
Monika Czarnowska-Cubała
; First Department of Radiology, Medical University of Gdańsk, Poland
Mariusz S. Wiglusz
; Department of Psychiatry, Medical University of Gdańsk, Poland
Wiesław Jerzy Cubała
; Department of Psychiatry, Medical University of Gdańsk, Poland
Katarzyna Jakuszkowiak-Wojten
; Department of Psychiatry, Medical University of Gdańsk, Poland
Jerzy Landowski
; Department of Psychiatry, Medical University of Gdańsk, Poland
Krzysztof Krysta
; Department of Psychiatry and Psychotherapy, Medical University of Silesia, Katowice, Poland
Abstract
Background: Syphilis is a sexually transmitted disease caused by Treponema pallium. The invasion of the central nervous system
is observed in 5-10% of untreated patients and may occur at any stage of the disease. The diagnosis of the early stage of syphilitic
infection is complex as many patients present either nonspecific symptoms or are asymptomatic. The identification of the most
common radiologic characteristics of neurosyphilis is important in the proper diagnosis of the infection.
Method: The paper reviews the MR findings in neurosyphilis presented in the literature with the emphasis on common traits,
patterns and factors in MR neuroimaging in neurosyphilis.
Results: Twelve papers were selected as suitable for analysis. Psychiatric symptomatology was the most common clinical
manifestations of neurosyphilis. As MRI findings in neurosyphilis were not highly specific it proved being the most sensitive
technique in detecting the changes in cerebral vasculitis commonly presenting with focal areas of high signal intensity in any
distribution with areas of infarction and hemorrhage observed at times. In neurosyphilis medium and small vessels are usually
involved. Parenchymal and meningeal enhancement was usually demonstrated. The most frequently involved arteries are middle
cerebral artery and branches of the basilar artery. However, normal findings were also common.
Conclusions: The most common MR diagnostic features are medium contrast enhancement, atrophy, white matter lesions,
cerebral infarction, oedema. Radiologists, neurologists, and psychiatrists should take neurosyphilis into consideration when facing
the differential diagnosis in central vascuclar disorders.
Keywords
syphilis; magnetic resonance; neuroimaging; neuroinfection; diagnostics
Hrčak ID:
266508
URI
Publication date:
26.8.2013.
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