[Recurrent ischemic strokes revealing Lyme meningovascularitis].
BACKGROUND
Infectious vascularitis is an unusual cause of ischemic stroke (IS). We report a case of Lyme meningovascularitis complicated with multiple IS.


METHODS
A 64-year-old man, without any cardiovascular risk factor, was admitted for a right hemiparesia with a left thalamic hypodensity on the initial cerebral CT scan. No cause for this presumed IS could be identified. Later, the patient developed cognitive impairment and a bilateral cerebellar syndrome. Multiple infarcts and multiple intracranial stenosis were seen on cerebral MRI with magnetic resonance angiography (MRA). Cerebrospinal fluid tests showed meningitis and positive Lyme serology with an intrathecal specific anti-Borrelia antibody index. Antibiotic treatment was followed by good biological and partial clinicoradiological outcome.


CONCLUSIONS
The diagnosis of Lyme neuroborreliosis should be entertained as a possible cause of IS in highly endemic zones.
Sparsa
L
L
Département de neurologie, hôpital Civil, hôpitaux universitaires, 1, place de l'Hôpital, 6700 Strasbourg, France.
Blanc
F
F
Lauer
V
V
Cretin
B
B
Marescaux
C
C
Wolff
V
V