Cerebral vasculitis and stroke in Lyme neuroborreliosis. Two case reports and review of current knowledge.
We report on 2 patients with cerebral vasculitis and stroke due to Lyme neuroborreliosis (LNB). Both patients had a prodromal stage involving headaches, and showed meningeal enhancement in addition to ischemic infarctions on brain magnetic resonance imaging and diffuse vasculitis on vascular imaging. Serological and cerebrospinal (CSF) fluid studies confirmed the diagnosis of active LNB. Ceftriaxone for 3 weeks led to an excellent recovery and improvements in the CSF examination findings. Stroke physicians should be aware of this rare presentation of LNB. A review of the current knowledge on cerebral vasculitis due to LNB is provided.
Topakian
Raffi
R
Department of Neurology, Academic Teaching Hospital Wagner-Jauregg, Linz, Austria. raffi.topakian@hotmail.com
Stieglbauer
Karl
K
Nussbaumer
Karin
K
Aichner
Franz T
FT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood / Q000134:cerebrospinal fluid; D025065:Borrelia burgdorferi / Q000276:immunology; D002545:Brain Ischemia / Q000382:microbiology; D002443:Ceftriaxone / Q000627:therapeutic use; D002533:Cerebral Angiography; D002648:Child; D002675:Child, Preschool; D005260:Female; D006261:Headache / Q000382:microbiology; D006801:Humans; D020852:Lyme Neuroborreliosis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D016896:Treatment Outcome; D020293:Vasculitis, Central Nervous System / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D002443:Ceftriaxone