Multiple embolic stroke due to aortic arch floating thrombus in latent tertiary syphilis.

A 57-year-old man was hospitalised in the emergency ward because of sudden appearance of nausea, vomiting, dizziness, nystagmus, motor aphasia associated to pain and cyanosis in the left arm. Doppler sonography detected a left omeral artery occlusion, due to acute embolism. The first brain CT scan was negative, but 24 h later evidenced multiple ischaemic infarctions in the brain (right cerebellar hemisphere, Broca's area; figure 1). Figure 1 Embolic stroke. Brain CT scan after 24 h from admittance showing multiple ischemic areas in the cerebellum (vermis and right hemisphere; A) and in the pars opercularis of the inferior frontal gyrus (B). Disseminated arterial multiple embolisms (involving in this case the brain and an upper limb) usually originate from fragments of cardiac …