tabes dorsalis
Neurosyphilis
with dementia and bilateral hippocampal atrophy on brain magnetic resonance imaging. Magnetic Resonance Imaging (MRI) of the brain. A/ Axial fluid attenuated inversion recovery (FLAIR). B/ Sagittal fluid attenuated inversion recovery (FLAIR). C/ Coronal 3D -T1-TFE. D/Coronal T2WI – TSE. All images are showing marked diffuse loss of brain parenchyma including mesiotemporal atrophy. Note that there are no areas of increased signal intensity in the FLAIR and T2W images.
Neurosyphilis
presenting with unusual hippocampal abnormalities on magnetic resonance imaging and positron emission tomography scans: a case report. Brain imaging studies. (a) Pre-treatment brain magnetic resonance imaging scan showing bilateral mesial temporal high T2 signal intensity (arrows). (b) Pre-treatment brain positron emission tomography/computed tomography brain scan revealing a focus of intensely increased 18F-fluorodeoxyglucose uptake limited to the head of the right hippocampus (arrow) on a background of globally decreased 18F-fluorodeoxyglucose uptake. (c) Post-treatment brain magnetic resonance imaging scan showing marked improvement in the previously identified bilateral hyperintensities, which were replaced by atrophy (arrows). (d) Post-treatment positron emission tomography brain scan showing normal 18F-fluorodeoxyglucose uptake in the right hippocampus.
Neurosyphilis
with a rare magnetic resonance imaging pattern confirmed by metagenomic next-generation sequencing: a case report. Initial and follow-up brain MRI findings. A–C Axial FLAIR images showed hyperintensities in bilateral medial and anterior temporal lobes, insula, right pulvinar of the thalami, precuneus, frontal and temporo-occipital lobes. D T1-contrast-enhanced MRI showed leptomeningeal enhancement in the right temporo-occipital region. E–G Post-treatment FLAIR images on 16th day of admission revealed marked improvement in the previously identified bilateral temporal, insula, precuneus, frontal and temporo-occipital hyperintensities. H Repeat gadolinium-enhanced MRI demonstrated disappearance of leptomeningeal contrast enhancement. The arrows indicated the lesions
Neurosyphilis
as a great imitator: a case report. Brain axial fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging of the patient (42-year-old male) showing asymmetrical brain atrophy, more pronounced in the right hemisphere
Gummatous
neurosyphilis in an elderly patient in the Australian outback: a case report. T1-weighted brain MRI demonstrating a thickening of the meninges that was initially considered a meningioma but subsequently re-diagnosed as a gumma (left, arrow)
Neurosyphilis
- Clinically dementia and radiologically meningoencephalitis. Dilated ventricular system slightly more on the right side. Prominence of temporal horns and hippocampal flattening more marked on the right side. No evidence of periventricular CSF seepage.
Neurosyphilis
- Clinically dementia and radiologically meningoencephalitis. T2WI MRI brain showing prominent extra-axial CSF spaces. Normal corpus callosum, brain stem and visualised cervical cord.
Neurosyphilis
- Clinically dementia and radiologically meningoencephalitis. T1WI MR brain showing prominent extra-axial CSF spaces and dilated ventricles more on the right.
Neurosyphilis
- Clinically dementia and radiologically meningoencephalitis. Post-contrast T1WI MR brain showing increased meningeal vascularity.
Neurosyphilis
- Clinically dementia and radiologically meningoencephalitis. Coronal precontrast FLAIR showing meningeal and sulcal hyperintensities.
Neurosyphilis
- Clinically dementia and radiologically meningoencephalitis. Coronal post-contrast FLAIR showing meningeal enhancement as shown by white arrows.
Neurosyphilis
- Clinically dementia and radiologically meningoencephalitis. Coronal precontrast FLAIR showing meningeal and sulcal hyperintensities.
Neurosyphilis
- Clinically dementia and radiologically meningoencephalitis. Coronal post-contrast FLAIR showing meningeal enhancement as shown by white arrows.
Neurosyphilis:
a case with bilateral mesiotemporal involvement. Axial FLAIR shows bilateral temporal hyperintensities with an enlarged temporal horn of the left lateral ventricle.
Neurosyphilis:
a case with bilateral mesiotemporal involvement. Coronal FLAIR shows cortical and subcortical white matter involvement of the left parietal lobe
Syphilis •
Tabes dorsalis - Ganzer Fall bei Radiopaedia
Tabes dorsalis is a form of tertiary late neurosyphilis in which there is demyelination of the posterior columns of the spinal cord.
For a general discussion, and for links to other system specific manifestations, please refer to the article on syphilis.
Clinical presentation
Patients present with symptoms related to dorsal column/nerve-root involvement such as weakness, sensory ataxia (tabetic gait), lancinating pain, hypoesthesia, and other manifestations of neurosyphilis such as personality changes. It has the longest latent period of any neurosyphilis manifestation between primary infection and onset of symptoms, averaging about 20 years.
Radiographic features
General
Radiologically, it can manifest as a Charcot joint (neuropathic arthropathy), usually involving either the hip, knee or spine.
MRI
MRI of the spinal cord demonstrates longitudinal T2-weighted hyperintensity in the dorsal columns of the spinal cord.
Differential diagnosis
General imaging differential considerations include:
- subacute combined degeneration of the cord: vitamin B12 deficiency related myelopathy of the cervical and thoracic cord
Siehe auch:
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Assoziationen und Differentialdiagnosen zu Neurolues:
