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Case No. 512
2019-04-01~2019-04-30
출제자 : 정미선
Hit : 335
| Period | 2019-04-01~2019-04-30 |
|---|---|
| Diagnosis | Neurosyphilis |
| Gender |
|
| Age | 61 |
| Clinical information | 61세 남자 왼쪽 얼굴에 central type facial palsy와 both leg weakness가 2달 전부터 있었다. 진단은? |
| Discussion | Neurosyphilis 1. Early neurosyphilis Acute syphilitic meningitis - Focal or diffuse leptomeningeal enhancement - Gummas : small nodules adjacent to the meninges - Meningomyelitis: m/c in thoracic spinal cord with or without involvement of the dorsal columns Meningovascular syphilis - Focal segmental vascular narrowing and ‘beading’ on MRA - Cortical or subcortical infarction in any vascular territory - Acute encephalitis : T2-weighted hyperintensities in medial temporal lobes atrophic change - Can be combined with the image findings of acute syphilitic meningitis. Otosyphilis : Gummas may be seen in the internal auditory canal 2. Late neurosyphilis General paresis: cerebral atrophy, both central and cortical atrophy Tabes dorsalis: Atrophy and longitudinal T2 high signal change in the dorsal columns of the spinal cord |
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Correct Answer
Semi-Correct Answer |