1: Neurologia. 2001 Jan;16(1):43-5. Links
Spontaneous brain hemorrhage associated with Lyme neuroborreliosis.
Seijo Martinez M, Grandes Ibanez J, Sanchez Herrero J, Garcia-Monco JC.

Servicio de Neurologia, Complexo Hospitalario de Pontevedra, Loureiro

We present the case of a patient with late neuroborreliosis and a
spontaneous temp{*filter*}lobe hemorrhage. Although ischemic stroke and
subarachnoid hemorrhage have been reported in association with Lyme
disease, intraparenchymal brain hemorrhage has not been previously
described in the course of this disease. The patient is a 48-year old
male with a progressive spastic paraparesis of months' duration who
presented acute headache, confusion, severe left hemiparesis with
sensory deficit and homonymous hemianopsia. A cranial computed
tomography scan showed an extensive right temp{*filter*}lobe hemorrhage with
subarachnoid invasion. Brain angiographic and angio-magnetic resonance
imaging studies excluded hemorrhage-predisposing vascular
abnormalities. Cerebrospinal fluid (CSF) studies disclosed mononuclear
pleocytosis with elevated protein levels. Both serum and CSF
anti-Borrelia titers were significantly increased, and serum Western
Blot showed bands to protein 34 (ops B), 57, 59 and 62. The patient was
treated with ceftriaxone for 4 weeks, with a favorable outcome. It is
suspected that cause of the hemorrhage was parenchymatous
Lyme-associated vascular damage and/or microaneurysmatic rupture.

PMID: 11234662 [PubMed - indexed for MEDLINE]