Neuroborreliosis-associated cerebral vasculitis—An update

Abstract Lyme borreliosis-associated diseases belong to the most frequent disorders in Europe that are transmitted by tick bites (ixodes ricinus). In addition to local inflammatory reactions, B. burgdorferi infections can also affect the central nervous system and cause strokes by neuroborreliosis-associated cerebral vasculitis. Criteria for the diagnosis are discussed and clinical cases are presented. Very likely, this disorder remains undetected in many cases because lumbar puncture is needed for diagnosis. With rapid antibiotic treatment vasculitic changes can be reversed and outcome is commonly good. However, if the basilar artery is affected by the vasculitis, outcome may be poor. In young patients presenting with repetitive ischemic episodes of the vertebrobasilar circulation and lacking vascular risk factors, Lyme neuroborreliosis-associated vasculitis should be ruled out.