Stroke due to lyme neuroborreliosis: changes in vessel wall contrast enhancement.
OBJECTIVE
Neuroborreliosis is a rare cause of stroke in children. We aim here to demonstrate the diagnostic value of gadolinium-enhanced magnetic resonance imaging (MRI) for demonstrating vessel wall abnormality in a child with brainstem stroke.


RESULTS
We report here the case of an 8-year-old boy with cerebral vasculitis and stroke due to Lyme neuroborreliosis. Imaging studies revealed the presence of ischemic lesions in the pons and cerebellum, with focal stenosis of the basilar artery on magnetic resonance angiography and focal gadolinium enhancement of the basilar artery wall. Nine months after treatment, clinical outcome was favorable, with no enhancement of the basilar artery.


CONCLUSIONS
Gadolinium-enhanced MRI provided additional information facilitating the diagnosis of vasculitis in a child with Lyme neuroborreliosis and stroke. The location of vessel wall enhancement was correlated with the topography of the acute infarct, and the lack of vessel lumen obstruction supported the diagnosis of vasculitis rather than any other cause.
Assistance Publique-Hôpitaux de Paris, Service de neurologie pédiatrique et Centre de Référence des maladies inflammatoires du cerveau, Hôpital Bicêtre, Le Kremlin-Bicêtre, France. suhailc1000@hotmail.com
Axel
A
Lebas
Frédérique
F
Toulgoat
Guillaume
G
Saliou
Béatrice
B
Husson
Marc
M
Tardieu
D001921:Brain / Q000473:pathology*; D002648:Child; D005682:Gadolinium; D006801:Humans; D020852:Lyme Neuroborreliosis / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D020521:Stroke / Q000209:etiology* / Q000473:pathology; D020293:Vasculitis, Central Nervous System / Q000209:etiology* / Q000473:pathology
D005682:Gadolinium