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Syphilis is caused by the Treponenum Pallidum spirochete.

Neurosyphilis is one of the tertiary forms of the disease.

It is manifested in the CNS as a chronic leptomeningeal process that progresses to brain parenchymal involvement with a vasculitic process and direct involvement of the brain by gummas.

Patients may present with headaches, cranial nerve palsies, strokes, hydrocephalus, or seizures.

Radiographic manifestations include dural thickening and a leptomeningeal process, strokes from the arteritis, and enhancing avascular lesions by direct involvement of the brain by gummas.