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

M L Touré; T H Baldé; M S Diallo; G Carlos Othon; N Camara; S D Barry; M M Konaté; F Sakadi; E Lamah; B Diallo; M Diakité; A Sakho; D Camara; S Condé; H Madandi; V Millimono; A K T Barry; M T Diallo; N Traoré; F D Kassa; A Koné; I S Souaré; J M Kadji; M H Diallo; A Tounkara; S A Rafkat; T M Diallo; J F Mara; F A Cissé; A Cissé

doi:10.1016/j.ensci.2023.100470

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

eNeurologicalSci. 2023 Jun 14:32:100470. doi: 10.1016/j.ensci.2023.100470. eCollection 2023 Sep.

Authors

M L Touré¹, T H Baldé², M S Diallo¹, G Carlos Othon¹, N Camara¹, S D Barry¹, M M Konaté³, F Sakadi⁴, E Lamah¹, B Diallo¹, M Diakité⁵, A Sakho², D Camara¹, S Condé¹, H Madandi¹, V Millimono¹, A K T Barry¹, M T Diallo¹, N Traoré¹, F D Kassa¹, A Koné¹, I S Souaré¹, J M Kadji¹, M H Diallo¹, A Tounkara¹, S A Rafkat¹, T M Diallo¹, J F Mara¹, F A Cissé¹, A Cissé¹

Affiliations

¹ Department of Neurology, CHU of Conakry, Guinea.
² Department of Radiology, Conakry University Hospital, Guinea.
³ Department of Neurology, National Hospital, Niamey, Niger.
⁴ Department of Neurology, Reference Hospital, N'Djamena, Chad.
⁵ Department of Hematology, Conakry University Hospital, Guinea.

Abstract

Introduction: 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.

Patients and methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Conakry-Guinea; Stroke; Syphilis.