Intracranial aneurysms in three patients with disseminated Lyme borreliosis: cause or chance association?

Abstract

Methods-Three patients with Borrelia burgdorferi infection and intracranial aneurysms are described. Results-All three patients had neurological symptoms. Perivascular and vasculitic lymphocytic inflammation were detected in the brain biopsy specimen of one patient. The aneurysm was located in the internal carotid arteries in two patients and in the basilar artery in one patient. The aneurysm ruptured in two patients. Conclusions-Cerebral lymphocytic vasculitis and intracranial aneurysms may be associated with B burgdorferi infection. It is suggested that inflammatory changes caused by B burgdorferi in vessel walls may be a pathogenetic mechanism for the formation of aneurysms. (J Neurol Neurosurg Psychiatry 1998;64:636-642)

Lyme borreliosis in Portugal caused by Borrelia lusitaniae? Clinical report on the first patient with a positive skin isolate

“…Even the episode of a nontraumatic subdural haematoma could be speculated spirochaetal related. It is known that spirochaetes are neurotropic, and infection may result in chronic inflammation of vascular walls of the central nervous system [21][22][23][24]. Finally, the non-specific aspect and the chronic evolution of the lesions in our patient is well in agreement with uncharacteristic dermatoses which were observed in Portuguese patients and of whom skin biopsies contained borrelial DNA which was detected by PCR [25,26].…”

Cerebrovascular Events in Lyme Neuroborreliosis

“…Hemorrhagic lesions, as in our third case, are less often encountered and are described as SAH or hemorrhagic stroke. 9,14,23,28,31 Signs of arachnoiditis, contrast enhancement in the blood vessel wall, and abnormalities of artery caliber observed on MRI support the hypothesis of vasculitis, sometimes confirmed by conventional angiography. 3,10,14,16,22,33,35 Possible radiological findings are both ischemic and hemorrhagic, and nonspecific.…”

Cerebral Vasculitis and Stroke in Lyme Neuroborreliosis

“…In syphilis, obliterative endarteritis of the vasa vasorum of large arteries can lead to aneurysm formation [23]. Interestingly, association of Borrelia infection with aneurysms of brain-supplying arteries has been reported in 3 patients, with 1 showing partial extracranial brain aneurysm formation [24]. Apart from that case, we are not aware of other publications on involvement of large extracranial brain-supplying arteries in LNB patients.…”