Stroke Due to Lyme Neuroborreliosis: Changes in Vessel Wall Contrast Enhancement

J Neuroimaging. 2012 Apr;22(2):210-2. doi: 10.1111/j.1552-6569.2010.00550.x. Epub 2010 Dec 1.

Abstract

Background and purpose: 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.

Publication types

  • Case Reports

MeSH terms

  • Brain / pathology*
  • Child
  • Gadolinium
  • Humans
  • Lyme Neuroborreliosis / complications*
  • Lyme Neuroborreliosis / pathology
  • Magnetic Resonance Imaging
  • Male
  • Stroke / etiology*
  • Stroke / pathology
  • Vasculitis, Central Nervous System / etiology*
  • Vasculitis, Central Nervous System / pathology

Substances

  • Gadolinium