Abstract
INTRODUCTION
Neurosyphilis is a chronic, infectious disease of the central nervous system. Pial arteriovenous fistulae (PAVF) are rare vascular malformations. Both can cause vascular damage, but it is quite rare for both to present at the same time.
PATIENT CONCERNS
Here we present a 66-year-old man with affective disorder, hypomnesia, and recent convulsions. Magnetic resonance imaging revealed cerebral swelling, hyperintensity in the cortex/subcortex, and multiple lacunar cerebral infarctions. Computed tomography angiography revealed the presence of a pial arteriovenous fistula.
DIAGNOSES
Based on laboratory tests and imaging, diagnoses of neurosyphilis and pial arteriovenous fistula were made.
INTERVENTIONS
Antisyphilis therapy was provided.
OUTCOMES
Symptoms improved and antisyphilis treatment continued as an outpatient. No intracranial hemorrhage was seen 6 months later.
CONCLUSION
Treponema pallidum infection may be related to the formation of PAVF, and may also promote the progression of it; however, further work is required to confirm this.
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