Subarachnoid hemorrhage due to Borrelia burgdorferi-associated vasculitis.
We report the case history of a patient who suffered a subarachnoid hemorrhage (SAH) in association with early Lyme neuroborreliosis. After a tick bite, this patient developed erythema chronicum migrans and complained of stinging radicular pain in both legs. A computed tomography (CT) scan was performed because of acute headache and nuchal rigidity, which revealed an occipital SAH. Cerebrospinal fluid analysis provided further evidence of acute neuroborreliosis. Digital substraction angiography showed irregularities in the right posterior cerebral artery, which might be due to vasculitis, but no aneurysms.
Jacobi
C
C
Department of Neurology, Ruprecht-Karl University, Heidelberg, Germany. christian_jacobi@med.uni-heidelberg.de
Schwark
C
C
Kress
B
B
Hug
A
A
Storch-Hagenlocher
B
B
Schwaninger
M
M
D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001733:Bites and Stings; D002444:Cefuroxime / Q000627:therapeutic use; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D020852:Lyme Neuroborreliosis / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged; D009553:Nimodipine / Q000627:therapeutic use; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid / Q000209:etiology / Q000382:microbiology*; D013987:Ticks; D014657:Vasculitis / Q000150:complications* / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D009553:Nimodipine; D002444:Cefuroxime