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. 2023 Jun 14:32:100470.
doi: 10.1016/j.ensci.2023.100470. eCollection 2023 Sep.

Ischemic strokes revealing neurosyphilis: Study of six (6) observations at the neurology Department of the University Hospital of Conakry

M L Touré  1 , T H Baldé  2 , M S Diallo  1 , G Carlos Othon  1 , N Camara  1 , S D Barry  1 , M M Konaté  3 , F Sakadi  4 , E Lamah  1 , B Diallo  1 , M Diakité  5 , A Sakho  2 , D Camara  1 , S Condé  1 , H Madandi  1 , V Millimono  1 , A K T Barry  1 , M T Diallo  1 , N Traoré  1 , F D Kassa  1 , A Koné  1 , I S Souaré  1 , J M Kadji  1 , M H Diallo  1 , A Tounkara  1 , S A Rafkat  1 , T M Diallo  1 , J F Mara  1 , F A Cissé  1 , A Cissé  1
Affiliations

Ischemic strokes revealing neurosyphilis: Study of six (6) observations at the neurology Department of the University Hospital of Conakry

M L Touré et al. eNeurologicalSci. .

Erratum in

Abstract

Introduction: 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.

Patients and methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Conakry-Guinea; Stroke; Syphilis.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Type II EEG trace without dominance as such with existence of irregular alpha rhythms without presence of pathological waves.
Fig. 2
Fig. 2
Type III EEG trace showing theta and delta rhythms, abnormal patterns in the form of occasional paroxysmal flashes.
Fig. 3
Fig. 3
Brain MRI T2 FLAIR sequence showing a right frontal hypersignal arguing in favor of a hemorrhagic infarction.
Fig. 4
Fig. 4
Anterior cerebral artery stenosis of syphilitic origin.
Fig. 5
Fig. 5
Brain MRI diffusion sequence showing bilateral frontal hypersignal arguing in favor of cerebral ischemia.
Fig. 6
Fig. 6
Angio-MRI bilateral anterior cerebral stenosis of syphilitic origin.
Fig. 7
Fig. 7
Angio-MRI T2 sequence showing an occlusion of the right superficial sylvian artery.
Fig. 8
Fig. 8
Brain MRI T2 FLAIR sequence showing a hypersignal in the territory of the right sylvian.
Fig. 9
Fig. 9
Angio-MRI left carotid stenosis of syphilitic origin.
Fig. 10
Fig. 10
Cerebral MRI T2 sequence showing a right hypersignal evoking a cerebral ischemia.
Fig. 11
Fig. 11
Multiple basilar and right anterior cerebral stenoses of syphilitic origin.
Fig. 12
Fig. 12
MRI image of vascular leukopathy of syphilitic origin.
See this image and copyright information in PMC

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