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Images in Neurology |

Basilar Artery Aneurysm in a Woman With Syphilis

Nathália Stela Visoná de Figueiredo, MD1; Débora Bartzen Moraes Angst, MD1; Lucas Silvestre Mendes, MD1; Michel Ferreira Machado, MD1; Maria Sheila Guimarães Rocha, MD, MSc1; Sônia Maria Dozzi Brucki, MD, PhD1
[+] Author Affiliations
1Department of Neurology, Hospital Santa Marcelina, São Paulo, Brazil
JAMA Neurol. 2015;72(6):720-721. doi:10.1001/jamaneurol.2015.0154.
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A woman in her 50s was evaluated in an outpatient memory clinic and was found to have had progressive cognitive impairment for at least 1 year, based on a Mini-Mental State Examination score of 20 out of 30 possible points, with a poor verbal fluency score of 4, and a reduced delayed recall (5 of 10 drawings). Her family observed that she developed a progressive commitment to the functional activities of daily living. During her life, she had arterial hypertension, but it was controlled. Laboratory and neuroimaging investigations were being scheduled at ambulatory care; however, she was admitted to the emergency department with a sudden neurologic deficit. The neurologic examination identified hemiparesis and tactile hypoesthesia on her left side.

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Magnetic Resonance Imaging Scans and Arteriograms of the Patient

A magnetic resonance imaging fluid-attenuated inversion recovery sequence of the patient’s brain reveals acute ischemic stroke in the right frontotemporoparietal region (A) and an aneurismal formation on the basilar artery (B). Arteriography documented a saccular aneurysm at this topography (C), with another in the right middle cerebral artery trifurcation (arrowhead), and a possible aneurysm on the left side (which is not shown) (D).

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