Abstract
A 9-year-old girl presented with an acute right-sided hemiparesis. Initially, the clinical presentation and stable vasculopathic abnormalities on MR and conventional angiography were suspicious of a so-called “transient cerebral arteriopathy”. Mild but persistent pleocytosis and an elevated CSF IgG index led to an extensive search for infectious and immunological causes of cerebral vasculitis, eventually revealing neuroborreliosis. Although rare, infectious and potentially treatable causes of arterial ischemic stroke should be considered in every child with a documented cerebral arteriopathy.
Key words
Neuroborreliosis - arteriopathy - stroke - child
References
-
1
Chabrier S, Rodesch G, Lasjaunias P, Tardieu M, Landrieu P, Sébire G.
Transient cerebral arteriopathy; a disorder recognized by serial angiograms in children with stroke.
J Child Neurol.
1998;
13
27-32
-
2
Chabrier S, Husson B, Lasjaunias P, Landrieu P, Tardieu M.
Stroke in childhood; outcome and recurrence risk by mechanisms in 59 patients.
J Child Neurol.
2000;
15
290-294
-
3
DeVeber G.
Risk factors for childhood stroke: Little folks have different strokes.
Ann Neurol.
2003;
53
149-150
-
4
Ganesan V, Prengler M, McShane M A, Wade A M, Kirkham F J.
Investigation of risk factors in children with arterial ischemic stroke.
Ann Neurol.
2003;
53
167-173
-
5
Hammers-Berggren S, Grondahl A, Karlsson M, Von Arbin M, Carlsson A, Stiernstedt G.
Screening for neuroborreliosis in patients with stroke.
Stroke.
1993;
24
1393-1396
-
6
Hansen K, Lebech A M.
The clinical and epidemiological profile of Lyme neuroborreliosis in Denmark 1985 - 1990. A prospective study of 187 patients with Borrelia burgdorferi specific intrathecal antibody production.
Brain.
1992;
115
399-423
-
7
Krüger H, Heim E, Schuknecht B, Scholz S.
Acute and chronic neuroborreliosis with and without CNS involvement: a clinical, MRI and HLA study of 27 cases.
J Neurol.
1991;
238
271-280
-
8
Stanek G, Strle F.
Lyme borreliosis.
Lancet.
2003;
362
1639-1647
-
9
Wilke M, Eiffert H, Christen H J, Hanefeld F.
Primarily chronic and cerebrovascular course of Lyme neuroborreliosis: case reports and literature review.
Arch Dis Child.
2000;
83
67-71
MD, PhD Kees P. J. Braun
Department of Paediatric Neurology
Wilhelmina Children's Hospital
University Medical Center Utrecht
PO Box 85090
3508 AB Utrecht
The Netherlands
Email: k.braun@wkz.azu.nl