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

• Published in: eNeurologicalSci Vol. 32; p. 100470
• Main Authors: Touré, M.L., Baldé, T.H., Diallo, M.S., Othon, G. Carlos, Camara, N., Barry, S.D., Konaté, M.M., Sakadi, F., Lamah, E., Diallo, B., Diakité, M., Sakho, A., Camara, D., Condé, S., Madandi, H., Millimono, V., Barry, A.K.T., Diallo, M.T., Traoré, N., Kassa, F.D., Koné, A., Souaré, I.S., Kadji, J.M., Diallo, M.H., Tounkara, A., Rafkat, S.A., Diallo, T.M., Mara, J.F., Cissé, F.A., Cissé, A.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.09.2023; Elsevier
• Subjects: Conakry-Guinea; Original; Stroke; Syphilis; Conakry-Guinea; Stroke; Syphilis
• ISSN: 2405-6502; 2405-6502
• DOI: 10.1016/j.ensci.2023.100470

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. 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. 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. 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. •Stroke is a major public health problem, and the etiological aspects are poorly studied and documented because of under-medicalization.•The syphilitic etiology was confirmed in six (6) patients 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 hypercellularity with predominantly lymphocytic pleiocytosis and hyperproteinorachy in the CSF in the absence of any other etiologies.