What is the role of CT scanning in the diagnosis of neurosyphilis?

Updated: Jul 17, 2018
  • Author: Richard P Knudsen, MD, FAAN, FAAP; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Answer

Areas of decreased density on CT scanning may correspond to ischemic infarction in vascular territories. They enhance with contrast. Magnetic resonance angiography has demonstrated irregularities of the basilar artery, the middle cerebral artery, the anterior cerebral artery, and the posterior cerebral artery. Angiography can detect concomitant atheromatous lesions unrelated to suspected syphilitic arteritis.

The syphilitic gummata appear hypodense with precontrast CT scanning. A variable degree of edema is identified. MRI demonstrates masses, which are hypointense to isointense on T1-weighted images and hyperintense on T2-weighted images. They densely enhance with contrast media. Differential considerations include glioma, meningeal metastasis, tuberculosis, sarcoidosis, and fungal infections.


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