Brainstem and cerebellar atrophy in neurosyphilis

A 54-year-old man suffered from serologically proven neurosyphilis with tet raspastic syndrome and bladder dysfunction. He showed a pronounced psychopa thy with cognitive decline and attention/concentration deficits. MRI showed slowly progressive cerebellar and brainstem atrophy, which has rarely been described over the past decades. During times of higher incidence and prev alence of neurosyphilis,infratentorial atrophy had been described occasiona lly, but today this clinical manifestation has been all but forgotten.