Stroke secondary to syphilis

Stroke secondary to syphilis

Definition:

Stroke secondary to syphilis is a complication of syphilis infection resulting in a loss of specific brain functions because of destruction of the blood vessels that supply the brain.

Alternative Names:

Syphilitic stroke

Causes, incidence, and risk factors:

Stroke caused by syphilis occurs as a life-threatening complication of long-standing syphilis infection. The infection causes inflammation and blockage of the arteries which supply the brain. Decreased blood flow causes brain tissue damage from lack of blood flow and oxygen (ischemia) and death of the tissues (infarction).

Risks include tertiary syphilis infection.

Symptoms:

Prodromal (preliminary) symptoms may precede the symptoms of stroke for about 1 to 4 weeks. These are:

Headache
Vertigo (abnormal sensation of movement)
Behavioral changes
Irritability

Symptoms of stroke include:

Weakness or the total inability to move a body part
Numbness, loss of sensation
Tingling or other abnormal sensations
Decreased or lost vision, partial or temporary
Language difficulties (aphasia)
Inability to recognize or identify sensory stimuli (agnosia)
Loss of memory
Vertigo (abnormal sensation of movement)
Loss of coordination
Swallowing difficulties
Personality changes
Mood and emotion changes
Urinary incontinence (lack of control over bladder)
Lack of control over the bowels
Consciousness changes
- Sleepy
- Stuporous, somnolent, lethargic
- Comatose, unconscious

Signs and tests:

A known history of syphilis may help to indicate syphilis as the cause of the stroke.

Tests may be used to confirm syphilis as the cause of the stroke, including:

Serum (blood) VDRL and RPR are screening tests. If positive FTA-Abs and MHATP are done to confirm the diagnosis.
CSF (cerebrospinal fluid) examination, showing positive CSF VDRL test, increased number of white blood cells, increased protein level, increased pressure of the fluid, or other abnormality.

The location and extent of the area of the brain involved in the stroke may be determined by:

Head CT scan
Head MRI scan
Angiography of the head or neck showing constriction or occlusion of the arteries

Treatment:

Symptoms are treated as with any stroke. Physical therapy, occupational therapy and other rehabilitation measures may be needed. Antibiotics are used in high doses to treat the syphilis infection. Analgesics may be needed to control severe headaches.

Expectations (prognosis):

The outcome depends on the extent of damage to the brain, the presence of other complications of late syphilis, and other factors.

Complications:

Complications of stroke
Complications of syphilis

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if you have any symptoms of impending stroke.

Prevention:

Stroke secondary to syphilis may be prevented by adequate treatment and follow-up for primary syphilis and secondary syphilis. Preventing the development of latent and tertiary syphilis prevents progressive damage, not only to blood vessels, but to the brain, spinal cord, bones, heart, and other tissues.

Review Date: 7/22/2001
Reviewed By: Galit Kleiner-Fisman, M.D., FRCP(C), Department of Neurology, University of Toronto, Toronto, Ontario, Canada. Review provided by VeriMed Healthcare Network.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2003 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.