Bilateral internal carotid artery dissection associated with prior syphilis: a case report and review of the literature

Antonio Marangi,1 Giuseppe Moretto,2 Manuel Cappellari,2 Nicola Micheletti,2 Giampaolo Tomelleri,2 Paolo Bovi2 1Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, Policlinico G.B Rossi, University of Verona, Verona, 2Stroke Unit, Division of Neurology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy Abstract: Bilateral internal carotid artery dissection is a rare entity, and its presentation may include cerebral ischemia. We describe the case of a 69-year-old man with ischemic stroke and radiological evidence of intimal flap of both internal carotid arteries suggestive for dissection. During the hospitalization, our patient was found positive for a previous syphilis infection. We conducted a review of the literature, with evidence of a few cases of ischemic stroke presumably related to a prior syphilis. The absence of major cardiovascular risk factors in our patient leads us to believe that an etiopathogenetic link may exist between these two conditions. Keywords: bilateral carotid dissection, ischemic stroke, neurosyphilis