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Lyme disease presenting as multiple ischaemic strokes
  1. Sui Li,
  2. Michal Vytopil,
  3. Kinan Hreib,
  4. Donald E Craven
  1. Department of Neurology, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA
  1. Correspondence to Dr Sui Li, Department of Neurology, Lahey Hospital & Medical Center, 41 Burlington Mall Rd, Burlington, MA 01805, USA; Sui.Li{at}Lahey.org

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.

  • LYME DISEASE
  • STROKE

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    Phil Smith Geraint N Fuller