[Neurosyphilis presenting as cerebellar stroke]

ABSTRACT

Neurosyphilis complicates 5-10% of untreated syphilis. Syphilitic cerebral ischemic stroke occurs in young individuals with variable frequency. Vertebrobasilar territory ischemia is rare. Syphilitic cerebellar infarct is exceptional. We report the case of 58 year-old-man, chronic smoker, who presented an acute cerebellar syndrome. Computed tomography scan of the brain showed a left cerebellar infarct. The serology tests of syphilis were positive in blood and cerebrospinal fluid. HIV serology was negative. The patient was treated successfully by penicillin G with good clinical course. Syphilitic cerebral ischemic stroke occurs usually in the Carotid territory. Our patient present a cerebellar infarct with positive syphilitic serology in blood and cerebrospinal fluid. The characteristic of our patient is the fast and complete recovery under treatment with penicillin G, and the rarity of case of syphilitic cerebellar ischemic vascular accident reported in the literature. One case of cerebellar stroke was reported. Syphilitic cerebellar ischemic stroke is exceptional. Systematic tests of syphilitic serology should always be performed when a young person has one or several cerebrovascular accident