Background

Meningovascular neurosyphilis, a form of early neurosyphilis, can cause infectious arteritis, which can be complicated by cerebral infarction. High-resolution vessel wall imaging (HR-VWI) is one of the techniques used to directly visualize the vessel wall. Herein, we present a rare case of meningovascular neurosyphilis, in which intracranial arterial vasculitis was evaluated using HR-VWI.

Case presentation

A 22-year-old man with no medical history of any condition was brought to the emergency room with one day history of right upper and lower extremity weakness. Diffusion-weighted magnetic resonance (MR) imaging showed a high signal from the left putamen to the corona radiata, and MR angiography showed stenosis of the right internal carotid artery (ICA) and the bilateral middle cerebral arteries (MCAs). HR-VWI showed thickening, along with smooth, intense, and concentric enhancement of the right ICA and the bilateral MCAs. The patient was diagnosed with neurosyphilis based on the findings of the blood tests and cerebrospinal fluid examination. The patient's symptoms gradually improved after treatment with intravenous penicillin G and oral antiplatelet agents. HR-VWI, performed approximately 6 months after the treatment, revealed improvement in the contrast enhancement of the vessel wall and the vascular stenosis.

Conclusion

To the best of our knowledge, this is the first report of meningovascular neurosyphilis that evaluated the course of treatment using HR-VWI. Our report highlights the effectiveness of HR-VWI to determine the effects of treatment on meningovascular neurosyphilis.

中文翻译：

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以急性缺血性中风为表现的脑膜血管神经梅毒的系列放射学检查结果：病例报告

背景

脑膜血管神经梅毒是早期神经梅毒的一种形式，可引起感染性动脉炎，可并发脑梗塞。高分辨率血管壁成像 (HR-VWI) 是用于直接可视化血管壁的技术之一。在此，我们介绍了一个罕见的脑膜血管神经梅毒病例，其中使用 HR-VWI 评估了颅内动脉血管炎。

案例展示

一名没有任何病史的 22 岁男性因右上肢和下肢无力一天病史被送往急诊室。弥散加权磁共振 (MR) 成像显示从左壳核到放射冠的高信号，磁共振血管造影显示右侧颈内动脉 (ICA) 和双侧大脑中动脉 (MCA) 狭窄。HR-VWI 显示增厚，右侧 ICA 和双侧 MCA 平滑、强烈、同心强化。根据血液检查和脑脊液检查结果，患者被诊断为神经梅毒。经静脉注射青霉素G及口服抗血小板药物治疗后，患者症状逐渐好转。HR-VWI，在治疗后约 6 个月进行，

结论

据我们所知，这是第一份使用 HR-VWI 评估治疗过程的脑膜血管神经梅毒报告。我们的报告强调了 HR-VWI 在确定脑膜血管神经梅毒治疗效果方面的有效性。