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Syphilis is a rare but treatable cause of stroke in certain patients. We present a case of basilar stenosis and pontine stroke from meningovascular syphilis with clinical and radiographic improvement following treatment.
Case report.
A 40-year-old right-handed man presented with left-sided weakness and a soft voice. The patient’s symptoms started with lightheadedness and nausea, and progressed over hours to left-sided weakness involving the face, arm, and leg. He was brought to his local emergency department, where he had a normal general examination and dense left hemiparesis. MRI showed an infarct in the medial aspect of the right pons and suggested decreased flow in the basilar artery. The patient was transferred to the Neurologic Intensive Care Unit at our hospital.
The review of systems was notable for lightheadedness on standing during the past month and a transient rash over the forearms 8 years prior. There was no known history of sexually transmitted disease.
The mental status was normal except for a pseudobulbar affect; it was unclear how long this symptom had been …
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