A Stroke in the Young with Surprising Recovery

Authors

• Dor Cohen Department of Internal Medicine T, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
• Gila Shpitalni Department of Internal Medicine T, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel and St. George’s, University of London School of Medicine, delivered by Nicosia University at the Chaim Sheba Medical Center, Tel Aviv, Israel
• Yulia Lifshitz Department of Internal Medicine T, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
• Sapir Anani Department of Internal Medicine T, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
• Ana Eyal Department of Diagnostic Imaging, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
• Gad Segal Department of Internal Medicine T, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel and St. George’s, University of London School of Medicine, delivered by Nicosia University at the Chaim Sheba Medical Center, Tel Aviv, Israel

gad.segal@sheba.health.gov.il

Keywords

Abstract

Introduction: The differential diagnosis of stroke in a comparatively young adult should always include cardiovascular aetiologies as well as central nervous system infection.
Case Presentation: A 56-year-old man, with no significant medical history, presented with headache, nausea and vomiting, and right hemiparesis. Routine stroke investigation was initiated, while CNS infection was also sought. Diagnoses of HIV infection, neurosyphilis, HCV and HBV were established. Targeted therapy resulted in prompt clinical improvement.
Conclusion: This case highlights the importance of considering CNS infection as a cause of neurological deficits in parallel with other investigations in cases of stroke in a comparatively young adult.