Stroke in younger patients is unusual and requires detailed diagnostic work-up due to possible rare causes such as syphilis infection. 1 Neurosyphilis is a central nervous system infection caused by Treponema pallidum (TP) that could be a treatable cause of stroke in some circumstances. 2 We present a young immunocompetent patient with meningovascular neurosyphilis, vasculitis of large intracranial arteries, and subsequent ischemic brain strokes. | CASE REPORTA 29-year-old white man was hospitalized at the Department of Neurology due to sudden motor dysphasia and right arm weakness. The onset of symptoms was preceded by a headache that occurred the day before hospital admission. The patient had a mild form of coronavirus disease 2019 6 months prior to admission, and a year earlier was assessed by a dermatologist due to a non-specific generalized rash without the need for specific medication.
Objective: To present 29-year-old patient with neurosyphilitic changes characterized by multiple acute ischemic brain strokes along with significant narrowing of several large intracranial arteries. After treatment of patient with ceftriaxone for 14 days following benzathine benzylpenicillin weekly for additional three weeks, meningovascular changes regressed.
Koronavirusna bolest u 2019. godini (COVID-19) uzrokovana je novootkrivenim korona virusom tipa 2 koji uzrokuje teški akutni respiratorni sindrom (SARS-CoV-2). Virus je otkriven u prosincu 2019. godine, a od strane Svjetske zdravstvene organizacije je, zbog broja oboljelih i proširenosti širom svijeta, proglašena pandemija. Klinička prezentacija COVID-19 varira od asimptomatskog do teškog oblika i smrtnog ishoda. Iako kliničkom slikom dominiraju respiratorne smetnje, mnogobrojne studije ukazuju na pojavu akutnih i kroničnih neuroloških komplikacija u skoro trećine oboljelih. Najčešći neurološki simptomi akutne faze COVID-19 su glavobolja, gubitak njuha i okusa, poremećaji stanja svijesti, encefalopatije, encefalitisi, moždani udar, bolovi u mišićima, epileptički napadaji, poliradikulopatije (GBS) te pojačan umor i netolerancija napora, poremećaji vegetativnih funkcija, kognitivne i psihičke smetnje u postinfekcijskoj fazi oboljenja. Potencijalni patofiziološki mehanizam nastanka neuroloških poremećaja u akutnoj fazi uključuje koagulopatije s udruženim hipoksično-ishemijskim oštećenjima, poremećajem krvno-moždane barijere, endoteliopatijama i neuroinvazijom virusa, udruženom s neuro-imunim odgovorom. Cilj ovog članka je prikazati najčešće akutne i kronične neurološke poremećaje vezane uz COVID-19 kod odraslih bolesnika kao i potencijalni patofiziološki mehanizam nastanka neuroloških poremećaja, a buduće epidemiološke studije o bolesnicima s COVID-19 bi trebali utvrditi pravu incidenciju neuroloških komplikacija COVID-19, razgraničiti specifične neurološke sindrome, postaviti dijagnostičke i terapijske protokole ta razjasniti mehanizam nastanka poremećaja.
Stroke related adult neuropsychiatric syndromes can be classified according to four axes: behavior or personality disorders, disorders of the perception identification of the self, other people, places, and time, cognitive disintegration (acute confusional state) and affective or mood disorders. Although cognitive dysfunctions or mood and affect disorders are very common after stroke and represent a very important factor in the recovery and rehabilitation, we will give short overview of rare behaviour or personality disorders related to stroke because we emphasize the need for a good knowledge of the these syndromes, in order to make valid diagnosis and start targeted etiological treatment.
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