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Front. Neurosci. | doi: 10.3389/fnins.2018.00100

Diagnosis and treatment of cerebral syphilitic gumma: a report of 3 cases

  • 1Department of Neurosurgery, First Affiliated Hospital of Wannan Medical College, China
  • 2Department of Dermatology and STD, First Affiliated Hospital of Wannan Medical College, China

Cerebral syphilitic gumma is very rare and is often pathologically confirmed following surgery. This study reports three patients with cerebral syphilitic gumma. The first case was a 62-year-old man who was admitted to our hospital due to speech arrest for 10 h. Head MRI showed a nodular signal shadow with a significant enhancement and a significant centerline shift. He subsequently received surgery, and cerebral syphilitic gumma was confirmed by postoperative pathology. The second patient was a 66-year-old man who was admitted to our hospital due to complaints of gradually decreasing right eye vision and headache for nearly 50 days. Enhanced MRI at admission indicated irregular clumping of high-signal mixed with low-signal foci on the frontal lobe. Subsequently, he was operatively treated and was confirmed to have cerebral syphilitic gumma by postoperative pathology. The third patient was a 37-year-old man who was admitted to our hospital due to dizziness for approximately 15 days. Head MRI indicated a slightly abnormal lamellar and longer T1, T2 signal shadow on the left side. He did not receive surgery, and his symptoms disappeared after anti-syphilitic treatment. Hence, we recommend a critical interpretation of preoperative imaging data, understanding the unique changes that arise in the brain that can be detected through imaging, and an analysis of the patient history and laboratory tests to re-evaluate the value of surgery, with the ultimate goal of performing a stabilizing treatment for cerebral syphilitic gumma.

Keywords: Neurosyphilis, Cerebral gumma, operation, diagnosis, Treatment

Received: 29 Aug 2017; Accepted: 09 Feb 2018.

Edited by:

Mikhail Lebedev, Duke University, United States

Reviewed by:

Jose F. Tellez-Zenteno, University of Saskatchewan, Canada
Juan C. Salazar, University of Connecticut Health Center, United States
Angelo Schenone, Università di Genova, Italy  

Copyright: © 2018 Shao, Qiang, Liu, Yuan, Tao and Ji. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Ms. Jin Tao, First Affiliated Hospital of Wannan Medical College, Department of Neurosurgery, Wuhu, Anhui Province, China, drbrainnet@163.com
Dr. Bihua Ji, First Affiliated Hospital of Wannan Medical College, Department of Dermatology and STD, Wuhu, Anhui Province, China, drshao@163.com