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Lyme neuroborreliosis: Progressive cerebral vasculitis responsive to cyclophosphamide. A case report and review of the literature
Less than 1 % of patients with Lyme Neuroborreliosis (LNB) present with a cerebrovascular event. Ischaemic strokes occur more commonly than parenchymal or subarachnoid haemorrhages. If cerebral vasculitis due to LNB is suspected, antibiotic treatment should be started immediately, which will normally lead to remission. Very rarely progression and recurrent strokes are observed despite sufficient antibiotic therapy, even if steroids are added. Currently there are no guidelines on the adequate treatment of cerebral vasculitis due to LNB which is not responsive to antibiotics and steroids, but in very few reported cases cyclo...
Source: Journal of Stroke and Cerebrovascular Diseases - June 17, 2023 Category: Neurology Authors: D ésirée Bajons, Roman Fröhlich, Waltraud Grandits, Miroslav Krstic, Helmut Rauschka, Regina Katzenschlager Source Type: research

COVID-19 Infection and Recurrent Stroke in Young Patients With Protein S Deficiency: A Case Report
Conclusions: SARS-CoV-2 infection potentializes the prothrombotic effect and vascular inflammation by accentuating protein S deficit. The place of steroids seems justifiable in the presence of symptoms of vasculitis in brain imaging.
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Q Fever, CNS Vasculitis, and Stroke: A Case Report
A 43-year-old male pet shop owner on leflunomide for seronegative rheumatoid arthritis presented locally with strange behavior and aphasia, preceded by flu-like symptoms and high fevers. Initial workup revealed cerebrospinal fluid lymphocytic pleocytosis (22 cells, 74% lymphocytes), for which he was started on empiric antimicrobial therapy. Magnetic resonance imaging of the brain revealed extensive, bilateral ischemic strokes (Figure). A transesophageal echocardiogram was negative. He was then transferred to our institution for further evaluation.
Source: The American Journal of Medicine - May 27, 2020 Category: General Medicine Authors: Jason Maljaars, Santiago Ortega-Gutierrez, Tracey Cho, Amir Shaban Tags: Clinical Communication to the Editor Source Type: research

A Case of Acute Ischemic Stroke and CNS vasculitis in a Patient with Q Fever
A 43-year-old male pet shop owner on leflunomide for seronegative rheumatoid arthritis presented locally with strange behavior and aphasia, preceded by flu-like symptoms and high fevers. Initial workup revealed cerebrospinal fluid lymphocytic pleocytosis (22 cells, 74% lymphocytes), for which he was started on empiric antimicrobial therapy. A brain MRI revealed extensive, bilateral ischemic strokes (Figure 1). A transesophageal echocardiogram (TEE) was negative. He was then transferred to our institution for further evaluation.
Source: The American Journal of Medicine - May 27, 2020 Category: General Medicine Authors: Jason Maljaars, Santiago Ortega-Gutierrez, Tracey Cho, Amir Shaban Tags: Clinical Communication to the Editor Source Type: research