Clinical Analysis of Three Neurosyphilis Patients Misdiagnosed as Cerebral Infarction Thrombolytic Therapy
Author(s): CHEN Li, ZHONG Hua
Pages: 296-300
Year: 2017 Issue: 3
Journal: Chinese Journal of Clinical Neurosciences
Keyword: neurosyphilis; cerebral infarction; thrombolytic therapy;
Abstract: Aim To analyze the clinical features, laboratory ifndings, electroencephalography (EEG) and neuroimaging of neurosyphilis presented with acute cerebral infarction as the principal manifestation to improve the diagnosis of neurosyphilis and reduce the mistreatment rate of thrombolysis patients in basic hospital.Methods Three meningovascular neurosyphilis patients with acute cerebral infarction were given intravenous thrombolytic therapy of rt-PA injection. The clinical manifestation, laboratory examinations, neuroimaging examinations, diagnosis and treatment outcomes were retrospectively analyzed. The short and long term prognosis with the NIHSS and mRS were assessed.Results Three male patients with the performance of acute cerebral infarction onset accepted the rt-PA injection thrombolytic therapy in the intravenous thrombolysis time, while the neurological deifcit symptoms worsen without the risk factors for cerebrovascular disease. Imaging examinations showed lesions coexistence of old and new, large and small, multiple asymmetric cerebral lesions and cerebral atrophy. Serum and cerebrospinal lfuid (CSF) treponema pallidum particle agglutination (TPPA) and toluidine red unheated serum test (TRUST) were positive in 3 cases. The patients received high-dose, full course of penicillin G treatment timely, the prognosis was well, NIHSS and mRS scores were significantly reduced.Conclusion Meningovascular neurosyphilis patients with acute cerebral infarction onset could not be identiifed in a short time. Intravenous thrombolytic treatment was poor, and there is no clear cause of cerebral infarction.To reduce the mistreatment rate of thrombolytic therapy,early syphilis serology and CSF examination was necessary. Large doses of penicillin treatment was effective.
Pages: 296-300
Year: 2017 Issue: 3
Journal: Chinese Journal of Clinical Neurosciences
Keyword: neurosyphilis; cerebral infarction; thrombolytic therapy;
Abstract: Aim To analyze the clinical features, laboratory ifndings, electroencephalography (EEG) and neuroimaging of neurosyphilis presented with acute cerebral infarction as the principal manifestation to improve the diagnosis of neurosyphilis and reduce the mistreatment rate of thrombolysis patients in basic hospital.Methods Three meningovascular neurosyphilis patients with acute cerebral infarction were given intravenous thrombolytic therapy of rt-PA injection. The clinical manifestation, laboratory examinations, neuroimaging examinations, diagnosis and treatment outcomes were retrospectively analyzed. The short and long term prognosis with the NIHSS and mRS were assessed.Results Three male patients with the performance of acute cerebral infarction onset accepted the rt-PA injection thrombolytic therapy in the intravenous thrombolysis time, while the neurological deifcit symptoms worsen without the risk factors for cerebrovascular disease. Imaging examinations showed lesions coexistence of old and new, large and small, multiple asymmetric cerebral lesions and cerebral atrophy. Serum and cerebrospinal lfuid (CSF) treponema pallidum particle agglutination (TPPA) and toluidine red unheated serum test (TRUST) were positive in 3 cases. The patients received high-dose, full course of penicillin G treatment timely, the prognosis was well, NIHSS and mRS scores were significantly reduced.Conclusion Meningovascular neurosyphilis patients with acute cerebral infarction onset could not be identiifed in a short time. Intravenous thrombolytic treatment was poor, and there is no clear cause of cerebral infarction.To reduce the mistreatment rate of thrombolytic therapy,early syphilis serology and CSF examination was necessary. Large doses of penicillin treatment was effective.
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