title: Lyme disease presenting as multiple ischaemic strokes.
abstract: A 46-year-old man presented with recurrent left hemiparesis and headache. MRI of brain showed an acute right pontine and subacute right thalamic infarcts and MR angiogram showed multiple intracranial arterial stenoses, suggesting cerebral vasculopathy. There was a cerebrospinal fluid lymphocytic pleocytosis with Borrelia burgdorferi antibodies. Central nervous system Lyme disease occasionally presents with ischaemic strokes; this case is unusual in showing vasculopathy on brain imaging, supporting meningovasculitis as the likely mechanism.
authors.affiliation: Department of Neurology, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA.
authors.forename: Sui
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Neurology, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA.
authors.forename: Michal
authors.initials: M
authors.lastname: Vytopil
authors.affiliation: Department of Neurology, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA.
authors.forename: Kinan
authors.initials: K
authors.lastname: Hreib
authors.affiliation: Department of Neurology, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Craven
mesh_terms: D002545:Brain Ischemia / Q000150:complications; D006801:Humans; D008193:Lyme Disease / Q000473:pathology* / Q000503:physiopathology*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000503:physiopathology*
keywords: LYME DISEASE; STROKE