Neurosyphilis can affect the central nervous system in the form of either meningovascular or parenchymatous neurosyphilis. Presentation varies from no symptoms to meningitis, tabes dorsalis, and general paresis1. Treponema pallidum can invade any vessel in the subarachnoid space resulting in thrombosis, ischemia, and infarction. Meningovascular syphilis most commonly affects the middle cerebral artery followed by basilar artery, causing stroke-like symptoms in a young person that can be easily mistaken as primary central nervous system …