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Stroke due to lyme neuroborreliosis: changes in vessel wall contrast enhancement

Axel Lebas1, Frédérique Toulgoat, Guillaume Saliou

  • 1Assistance 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

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|December 3, 2010
PubMed
Abstract

Insights

Gadolinium-enhanced MRI aids in diagnosing pediatric stroke caused by Lyme neuroborreliosis. This imaging technique reveals vessel wall abnormalities, crucial for identifying vasculitis in children with brainstem stroke.

Area of Science:

  • Pediatric neurology
  • Infectious diseases
  • Neuroradiology

Background:

  • Neuroborreliosis is an uncommon cause of stroke in pediatric patients.
  • Prompt diagnosis is essential for effective treatment and improved outcomes.

Observation:

  • A case study of an 8-year-old boy presenting with cerebral vasculitis and stroke secondary to Lyme neuroborreliosis.
  • Magnetic resonance angiography showed basilar artery stenosis, while gadolinium-enhanced MRI revealed focal basilar artery wall enhancement.

Findings:

  • Gadolinium-enhanced MRI demonstrated vessel wall abnormalities, aiding in the diagnosis of vasculitis.
  • The enhancement pattern correlated with the infarct location, and the absence of lumen obstruction supported vasculitis over other etiologies.
  • Favorable clinical outcome was observed nine months post-treatment, with resolution of basilar artery enhancement.

Implications:

  • Gadolinium-enhanced MRI is a valuable tool for diagnosing vasculitis in pediatric neuroborreliosis.
  • This imaging modality can differentiate vasculitis from other causes of stroke by visualizing vessel wall inflammation.
  • Early and accurate diagnosis through advanced imaging can lead to timely intervention and better patient prognoses.

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