{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T01:15:45Z","timestamp":1793927745856,"version":"4.8.0"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Neuroborreliosis is a neurological manifestation resulting from bacteria of the <jats:italic>Borrelia burgdorferi<\/jats:italic> sensu lato complex infection. This condition presents with a range of heterogeneous symptoms affecting the central and peripheral nervous systems, manifesting with varying frequency in adults and children. In rare cases, the infection may lead to ischemic stroke, however the pathogenesis remains incompletely understood due to its infrequent occurrence. The development of ischemic stroke in these patients is likely mediated by arterial inflammation, leading to critical narrowing of blood vessels and subsequently to ischemia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>This paper presents the case of a 16-year-old patient diagnosed with ischemic stroke. The patient was treated with enoxaparin until exclusion of cardioembolism and vascular dissection. After excluding other potential causes, neuroborreliosis was considered highly probable due to a history of multiple tick bites and elevated titers of antibodies against <jats:italic>Borrelia burgdorferi<\/jats:italic> in both blood serum and cerebrospinal fluid. Therefore, the patient received antibiotic therapy. In long-term follow-up, he has shown significant improvement, returning to his pre-stroke level of function.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The lack of literature on the subject contributes to the diagnostic and therapeutic challenges in affected patients. The patient's condition improved as a result of early recognition and prompt initiation of treatment and rehabilitation. It is becoming increasingly important to differentiate paediatric patients with a diagnosis of ischemic stroke also with regard to neuroborreliosis in endemic regions.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s10072-025-08296-3","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T23:43:20Z","timestamp":1750290200000},"page":"4497-4503","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Case report of ischemic stroke in a child secondary to neuroborreliosis"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8265-5232","authenticated-orcid":false,"given":"Dawid","family":"Zakrzewski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6567-1692","authenticated-orcid":false,"given":"Mateusz","family":"Tomkiewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiktoria","family":"Kubziakowska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4562-1882","authenticated-orcid":false,"given":"Marta","family":"Zawadzka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakub","family":"Szymarek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9405-5066","authenticated-orcid":false,"given":"Maria","family":"Mazurkiewicz-Be\u0142dzi\u0144ska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"issue":"3","key":"8296_CR1","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.idc.2022.03.004","volume":"36","author":"P Mead","year":"2022","unstructured":"Mead P (2022S) Epidemiology of Lyme disease. Infect Dis Clin North Am 36(3):495\u2013521. https:\/\/doi.org\/10.1016\/j.idc.2022.03.004","journal-title":"Infect Dis Clin North Am"},{"issue":"3","key":"8296_CR2","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1007\/s00436-022-07445-3","volume":"121","author":"A Steinbrink","year":"2022","unstructured":"Steinbrink A, Brugger K, Margos G, Kraiczy P, Klimpel S (2022) The evolving story of Borrelia burgdorferi sensu lato transmission in Europe. Parasitol Res 121(3):781\u2013803. https:\/\/doi.org\/10.1007\/s00436-022-07445-3","journal-title":"Parasitol Res"},{"issue":"3","key":"8296_CR3","doi-asserted-by":"publisher","first-page":"e33","DOI":"10.1371\/journal.ppat.0030033","volume":"3","author":"G Neelakanta","year":"2007","unstructured":"Neelakanta G, Li X, Pal U, Liu X, Beck DS, DePonte K, Fish D, Kantor FS, Fikrig E (2007) Outer surface protein B is critical for Borrelia burgdorferi adherence and survival within Ixodes ticks. PLoS Pathog 3(3):e33. https:\/\/doi.org\/10.1371\/journal.ppat.0030033","journal-title":"PLoS Pathog"},{"key":"8296_CR4","doi-asserted-by":"publisher","unstructured":"Cardenas-de la Garza JA, De la Cruz-Valadez E, Ocampo-Candiani J, Welsh O (2019) Clinical spectrum of Lyme disease. Eur J Clin Microbiol Infect Dis 38(2):201\u2013208. https:\/\/doi.org\/10.1007\/s10096-018-3417-1","DOI":"10.1007\/s10096-018-3417-1"},{"key":"8296_CR5","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1007\/s004150050216","volume":"245","author":"P Oschmann","year":"1998","unstructured":"Oschmann P, Dorndorf W, Hornig C, Sch\u00e4fer C, Wellensiek HJ, Pflughaupt KW (1998) Stages and syndromes of neuroborreliosis. J Neurol 245:262\u2013272. https:\/\/doi.org\/10.1007\/s004150050216","journal-title":"J Neurol"},{"key":"8296_CR6","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1111\/j.1468-1331.2009.02862.x","volume":"17","author":"\u00c5 Mygland","year":"2010","unstructured":"Mygland \u00c5, Lj\u00f8stad U, Fingerle V, Rupprecht T, Schmutzhard E, Steiner I (2010) EFNS guidelines on the diagnosis and management of European lyme neuroborreliosis: guidelines on neuroborreliosis. Eur J Neurol 17:8-e4. https:\/\/doi.org\/10.1111\/j.1468-1331.2009.02862.x","journal-title":"Eur J Neurol"},{"issue":"3","key":"8296_CR7","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.arcped.2019.02.010","volume":"26","author":"H Guet-Revillet","year":"2019","unstructured":"Guet-Revillet H, Levy C, Vallet C, Maghraoui-Slim V, Dommergues MA, Hentgen V, Paget C, Laugel V, Cohen R, Ferroni A (2019) Lyme neuroborreliosis in children: Report of nine cases and a review of the literature. Arch Pediatr 26(3):133\u2013137. https:\/\/doi.org\/10.1016\/j.arcped.2019.02.010","journal-title":"Arch Pediatr"},{"key":"8296_CR8","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1136\/adc.2009.176529","volume":"95","author":"DM Broekhuijsen-van Henten","year":"2010","unstructured":"Broekhuijsen-van Henten DM, Braun KP, Wolfs TF (2010) Clinical presentation of childhood neuroborreliosis; neurological examination may be normal. Arch Dis Child 95:910\u2013914. https:\/\/doi.org\/10.1136\/adc.2009.176529","journal-title":"Arch Dis Child"},{"key":"8296_CR9","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1097\/INF.0000000000001653","volume":"36","author":"L S\u00f6dermark","year":"2017","unstructured":"S\u00f6dermark L, Sigurdsson V, N\u00e4s W, Wall P, Trollfors B (2017) Neuroborreliosis in Swedish children: a population-based study on incidence and clinical characteristics. Pediatric Infect Dis J 36:1052\u20131056. https:\/\/doi.org\/10.1097\/INF.0000000000001653","journal-title":"Pediatric Infect Dis J"},{"issue":"10","key":"8296_CR10","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.3390\/brainsci13101388","volume":"13","author":"BH Akkurt","year":"2023","unstructured":"Akkurt BH, Kraehling H, Nacul NG, Elsharkawy M, Schmidt-Pogoda A, Minnerup J, Stracke CP, Schwindt W (2023) Vasculitis and ischemic stroke in lyme neuroborreliosis-interventional management approach and literature review. Brain Sci 13(10):1388. https:\/\/doi.org\/10.3390\/brainsci13101388","journal-title":"Brain Sci"},{"key":"8296_CR11","doi-asserted-by":"publisher","unstructured":"Zajkowska J, Garkowski A, Moniuszko A, Czupryna P, Ptaszy\u0144ska-Sarosiek I, Taras\u00f3w E, \u2026 Pancewicz S (2014) Vasculitis and stroke due to Lyme neuroborreliosis \u2013 a review. Infect Dis 47(1):1\u20136. https:\/\/doi.org\/10.3109\/00365548.2014.961544","DOI":"10.3109\/00365548.2014.961544"},{"issue":"427","key":"8296_CR12","doi-asserted-by":"publisher","first-page":"117544","DOI":"10.1016\/j.jns.2021.117544","volume":"15","author":"M Mironova","year":"2021","unstructured":"Mironova M, Kortela E, Kurkela S, Kanerva M, Curtze S (2021) Lyme neuroborreliosis-associated cerebrovascular events in the finnish endemic area. J Neurol Sci 15(427):117544. https:\/\/doi.org\/10.1016\/j.jns.2021.117544","journal-title":"J Neurol Sci"},{"issue":"1","key":"8296_CR13","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.ejpn.2017.10.010","volume":"22","author":"O Monteventi","year":"2018","unstructured":"Monteventi O, Steinlin M, Reg\u00e9nyi M, Roulet-Perez E, Weber P, Fluss J (2018) Pediatric stroke related to Lyme neuroborreliosis: data from the swiss neuropaediatric stroke registry and literature review. Eur J Paediatr Neurol 22(1):113\u2013121. https:\/\/doi.org\/10.1016\/j.ejpn.2017.10.010","journal-title":"Eur J Paediatr Neurol"},{"key":"8296_CR14","doi-asserted-by":"publisher","unstructured":"Steere AC, Strle F, Wormser GP, Hu LT, Branda JA, Hovius JW, Li X, Mead PS (2016) Lyme borreliosis. Nat Rev Dis Primers 2:16090. https:\/\/doi.org\/10.1038\/nrdp.2016.90. Erratum in: Nat Rev Dis Primers. 2017 Aug 03;3:17062. hhttps:\/\/doi.org\/10.1038\/nrdp.2017.62","DOI":"10.1038\/nrdp.2016.90"},{"issue":"2","key":"8296_CR15","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1056\/NEJM200107123450207","volume":"345","author":"AC Steere","year":"2001","unstructured":"Steere AC (2001) Lyme disease. N Engl J Med 345(2):115\u2013125. https:\/\/doi.org\/10.1056\/NEJM200107123450207","journal-title":"N Engl J Med"},{"issue":"8","key":"8296_CR16","doi-asserted-by":"publisher","first-page":"146","DOI":"10.3389\/fneur.2017.00146","volume":"20","author":"A Garkowski","year":"2017","unstructured":"Garkowski A, Zajkowska J, Zajkowska A, Ku\u0142akowska A, Zajkowska O, Kubas B, Jurgilewicz D, H\u0142adu\u0144ski M, \u0141ebkowska U (2017) Cerebrovascular manifestations of Lyme neuroborreliosis-a systematic review of published cases. Front Neurol 20(8):146. https:\/\/doi.org\/10.3389\/fneur.2017.00146","journal-title":"Front Neurol"},{"issue":"9","key":"8296_CR17","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1016\/S1474-4422(07)70203-X","volume":"6","author":"R Topakian","year":"2007","unstructured":"Topakian R, Stieglbauer K, Aichner FT (2007) Unexplained cerebral vasculitis and stroke: keep Lyme neuroborreliosis in mind. Lancet Neurol 6(9):756\u2013757. https:\/\/doi.org\/10.1016\/S1474-4422(07)70203-X. (author reply 757)","journal-title":"Lancet Neurol"},{"issue":"1","key":"8296_CR18","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1186\/s13071-021-04849-5","volume":"14","author":"A Pawe\u0142czyk","year":"2021","unstructured":"Pawe\u0142czyk A, Bednarska M, Hamera A, Religa E, Poryszewska M, Mierzejewska EJ, Welc-Fal\u0119ciak R (2021) Long-term study of Borrelia and Babesia prevalence and co-infection in Ixodes ricinus and Dermacentor recticulatus ticks removed from humans in Poland, 2016\u20132019. Parasit Vectors 14(1):348. https:\/\/doi.org\/10.1186\/s13071-021-04849-5","journal-title":"Parasit Vectors"},{"issue":"8","key":"8296_CR19","doi-asserted-by":"publisher","first-page":"2017","DOI":"10.3201\/eid2708.204763","volume":"27","author":"AR Marques","year":"2021","unstructured":"Marques AR, Strle F, Wormser GP (2021) Comparison of Lyme disease in the United States and Europe. Emerg Infect Dis 27(8):2017\u20132024. https:\/\/doi.org\/10.3201\/eid2708.204763","journal-title":"Emerg Infect Dis"},{"issue":"2","key":"8296_CR20","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1586\/14737175.2015.1134321","volume":"16","author":"FJ Carod Artal","year":"2016","unstructured":"Carod Artal FJ (2016) Clinical management of infectious cerebral vasculitides. Expert Rev Neurother 16(2):205\u2013221. https:\/\/doi.org\/10.1586\/14737175.2015.1134321","journal-title":"Expert Rev Neurother"},{"key":"8296_CR21","doi-asserted-by":"publisher","unstructured":"Zedde M, Quatrale R, Andreone V, Pezzella FR, Micieli G, Cortelli P, Sette MD, Pascarella R (2025) Post-infectious central nervous system vasculitides in adults: an underdiagnosed and treatable disease part II. Neuroimaging of selected etiologies : Part II. Neuroimaging of selected etiologies. Neurol Sci 46(3):1073\u20131086. https:\/\/doi.org\/10.1007\/s10072-024-07938-2","DOI":"10.1007\/s10072-024-07938-2"},{"issue":"5","key":"8296_CR22","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1159\/000155982","volume":"26","author":"R Topakian","year":"2008","unstructured":"Topakian R, Stieglbauer K, Nussbaumer K, Aichner FT (2008) Cerebral vasculitis and stroke in Lyme neuroborreliosis. Two case reports and review of current knowledge. Cerebrovasc Dis 26(5):455\u2013461. https:\/\/doi.org\/10.1159\/000155982","journal-title":"Cerebrovasc Dis"},{"issue":"Pt 6","key":"8296_CR23","doi-asserted-by":"publisher","first-page":"2143","DOI":"10.1093\/brain\/119.6.2143","volume":"119","author":"J Oksi","year":"1996","unstructured":"Oksi J, Kalimo H, Marttila RJ, Marjam\u00e4ki M, Sonninen P, Nikoskelainen J, Viljanen MK (1996) Inflammatory brain changes in Lyme borreliosis. A report on three patients and review of literature. Brain 119(Pt 6):2143\u20132154. https:\/\/doi.org\/10.1093\/brain\/119.6.2143","journal-title":"Brain"},{"key":"8296_CR24","doi-asserted-by":"publisher","unstructured":"Winter Y, Simon OJ, Spreer A, Othman AE, Altmann S, Brandt M, Barlinn K, Back T, Civelek A, Bach JP, Schiffer J, Dresel C, Meuth S, Bittner S, Groppa S, Brummer T (2024) Cerebral vasculitis as clinical manifestation of neuroborreliosis: pattern of vascular pathology and prognostic factors of outcome. Int J Stroke 16:17474930241287326. https:\/\/doi.org\/10.1177\/17474930241287326","DOI":"10.1177\/17474930241287326"},{"issue":"5","key":"8296_CR25","doi-asserted-by":"publisher","first-page":"1344","DOI":"10.1016\/j.ajpath.2015.01.024","volume":"185","author":"G Ramesh","year":"2015","unstructured":"Ramesh G, Didier PJ, England JD, Santana-Gould L, Doyle-Meyers LA, Martin DS, Jacobs MB, Philipp MT (2015) Inflammation in the pathogenesis of lyme neuroborreliosis. Am J Pathol 185(5):1344\u20131360. https:\/\/doi.org\/10.1016\/j.ajpath.2015.01.024","journal-title":"Am J Pathol"},{"issue":"1","key":"8296_CR26","doi-asserted-by":"publisher","first-page":"e2021045","DOI":"10.4084\/MJHID.2021.045","volume":"13","author":"N Semeraro","year":"2021","unstructured":"Semeraro N, Colucci M (2021) The prothrombotic state associated with SARS-CoV-2 infection: pathophysiological aspects. Mediterr J Hematol Infect Dis 13(1):e2021045. https:\/\/doi.org\/10.4084\/MJHID.2021.045","journal-title":"Mediterr J Hematol Infect Dis"},{"issue":"2","key":"8296_CR27","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.hfc.2022.08.008","volume":"19","author":"R Kankaria","year":"2023","unstructured":"Kankaria R, Sanina C, Gabr M, Wiley J, Bortnick AE (2023) Extracardiac prothrombotic effects of COVID-19. Heart Fail Clin 19(2):213\u2013220. https:\/\/doi.org\/10.1016\/j.hfc.2022.08.008","journal-title":"Heart Fail Clin"},{"issue":"3","key":"8296_CR28","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1080\/09537104.2020.1817360","volume":"32","author":"K Martinod","year":"2021","unstructured":"Martinod K, Deppermann C (2021) Immunothrombosis and thromboinflammation in host defense and disease. Platelets 32(3):314\u2013324. https:\/\/doi.org\/10.1080\/09537104.2020.1817360","journal-title":"Platelets"},{"issue":"12","key":"8296_CR29","doi-asserted-by":"publisher","first-page":"2017","DOI":"10.1161\/CIRCRESAHA.121.318225","volume":"128","author":"ME Colling","year":"2021","unstructured":"Colling ME, Tourdot BE, Kanthi Y (2021) Inflammation, infection and venous thromboembolism. Circ Res 128(12):2017\u20132036. https:\/\/doi.org\/10.1161\/CIRCRESAHA.121.318225","journal-title":"Circ Res"},{"key":"8296_CR30","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s00431-021-04212-x","volume":"181","author":"M Mastrangelo","year":"2022","unstructured":"Mastrangelo M, Giordo L, Ricciardi G et al (2022) Acute ischemic stroke in childhood: a comprehensive review. Eur J Pediatr 181:45\u201358. https:\/\/doi.org\/10.1007\/s00431-021-04212-x","journal-title":"Eur J Pediatr"},{"issue":"1","key":"8296_CR31","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1161\/STROKEAHA.118.023060","volume":"50","author":"M B\u00f6hmer","year":"2019","unstructured":"B\u00f6hmer M, Niederstadt T, Heindel W, Wildgruber M, Str\u00e4ter R, Hanning U, Kemmling A, Sporns PB (2019) Impact of childhood arterial ischemic stroke standardized classification and diagnostic evaluation classification on further course of arteriopathy and recurrence of childhood stroke. Stroke 50(1):83\u201387. https:\/\/doi.org\/10.1161\/STROKEAHA.118.023060","journal-title":"Stroke"},{"issue":"1","key":"8296_CR32","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.nic.2023.07.009","volume":"34","author":"O Hamam","year":"2024","unstructured":"Hamam O, Cartmell SC, Romero JM (2024) Imaging of small artery vasculitis. Neuroimaging Clin N Am 34(1):67\u201379. https:\/\/doi.org\/10.1016\/j.nic.2023.07.009","journal-title":"Neuroimaging Clin N Am"},{"issue":"9843","key":"8296_CR33","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1016\/S0140-6736(12)60069-5","volume":"380","author":"C Salvarani","year":"2012","unstructured":"Salvarani C, Brown RD Jr, Hunder GG (2012) Adult primary central nervous system vasculitis. Lancet 380(9843):767\u2013777. https:\/\/doi.org\/10.1016\/S0140-6736(12)60069-5","journal-title":"Lancet"},{"issue":"5","key":"8296_CR34","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1007\/s13244-018-0646-x","volume":"9","author":"ES Lindland","year":"2018","unstructured":"Lindland ES, Solheim AM, Andreassen S, Quist-Paulsen E, Eikeland R, Lj\u00f8stad U, Mygland \u00c5, Elsais A, Nygaard GO, Lorentzen \u00c5R, Harbo HF, Beyer MK (2018) Imaging in Lyme neuroborreliosis. Insights Imaging 9(5):833\u2013844. https:\/\/doi.org\/10.1007\/s13244-018-0646-x","journal-title":"Insights Imaging"},{"key":"8296_CR35","doi-asserted-by":"crossref","unstructured":"Zedde M, Quatrale R, Andreone V, Pezzella FR, Micieli G, Cortelli P, Sette MD, Pascarella R (2025) Post-infectious central nervous system vasculitides in adults: an underdiagnosed and treatable disease part II. Neuroimaging of selected etiologies : Part II. Neuroimaging of selected etiologies. Neurol Sci 46:633\u2013650","DOI":"10.1007\/s10072-024-07935-5"},{"issue":"1","key":"8296_CR36","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1186\/s12879-023-08259-z","volume":"23","author":"S Riescher","year":"2023","unstructured":"Riescher S, Dos Santos A, Lecomte R, Lenoble C, Guillon B (2023) A case report of unilateral cerebral vasculitis in adults: keep in mind Lyme neuroborreliosis. BMC Infect Dis 23(1):283. https:\/\/doi.org\/10.1186\/s12879-023-08259-z","journal-title":"BMC Infect Dis"},{"issue":"9","key":"8296_CR37","doi-asserted-by":"publisher","first-page":"3155","DOI":"10.1111\/ene.14962","volume":"28","author":"D Stupica","year":"2021","unstructured":"Stupica D, Bajrovi\u0107 FF, Blagus R, Cerar Ki\u0161ek T, Collinet-Adler S, Lah A, Levstek E, Ru\u017ei\u0107-Sablji\u0107 E (2021) Clinical manifestations and long-term outcome of early Lyme neuroborreliosis according to the European Federation of Neurological Societies diagnostic criteria (definite versus possible) in central Europe. A retrospective cohort study. Eur J Neurol 28(9):3155\u20133166. https:\/\/doi.org\/10.1111\/ene.14962","journal-title":"Eur J Neurol"},{"key":"8296_CR38","doi-asserted-by":"publisher","unstructured":"Mygland A, Lj\u00f8stad U, Fingerle V, Rupprecht T, Schmutzhard E, Steiner I (2010) European Federation of Neurological Societies. EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis. Eur J Neurol 17(1):8\u201316, e1\u20134. https:\/\/doi.org\/10.1111\/j.1468-1331.2009.02862.x","DOI":"10.1111\/j.1468-1331.2009.02862.x"},{"key":"8296_CR39","doi-asserted-by":"publisher","unstructured":"Rauer S, Kastenbauer S, Hofmann H, Fingerle V, Huppertz HI, Hunfeld KP, Krause A, Ruf B, Dersch R, Consensus group (2020) Guidelines for diagnosis and treatment in neurology - Lyme neuroborreliosis. Ger Med Sci. https:\/\/doi.org\/10.3205\/000279","DOI":"10.3205\/000279"},{"key":"8296_CR40","doi-asserted-by":"publisher","unstructured":"Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, Biller J, Brown M, Demaerschalk BM, Hoh B, Jauch EC, Kidwell CS, Leslie-Mazwi TM, Ovbiagele B, Scott PA, Sheth KN, Southerland AM, Summers DV, Tirschwell DL (2019) Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association\/American Stroke Association. Stroke 50(12):e344-e418. https:\/\/doi.org\/10.1161\/STR.0000000000000211. Erratum in: Stroke. 2019 Dec;50(12):e440-e441. https:\/\/doi.org\/10.1161\/STR.0000000000000215","DOI":"10.1161\/STR.0000000000000211"},{"issue":"8","key":"8296_CR41","doi-asserted-by":"publisher","first-page":"e8","DOI":"10.1136\/neurintsurg-2018-014569","volume":"15","author":"G Turc","year":"2023","unstructured":"Turc G, Bhogal P, Fischer U, Khatri P, Lobotesis K, Mazighi M, Schellinger PD, Toni D, de Vries J, White P, Fiehler J (2023) European Stroke Organisation (ESO) - European Society for Minimally Invasive Neurological Therapy (ESMINT) guidelines on mechanical thrombectomy in acute ischemic stroke. J Neurointerv Surg 15(8):e8. https:\/\/doi.org\/10.1136\/neurintsurg-2018-014569","journal-title":"J Neurointerv Surg"},{"key":"8296_CR42","doi-asserted-by":"publisher","unstructured":"Berge E, Whiteley W, Audebert H, De Marchis GM, Fonseca AC, Padiglioni C, de la Ossa NP, Strbian D, Tsivgoulis G, Turc G (2021) European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. Eur Stroke J 6(1):I-LXII. https:\/\/doi.org\/10.1177\/2396987321989865.","DOI":"10.1177\/2396987321989865"},{"issue":"3","key":"8296_CR43","first-page":"243","volume":"57","author":"E Pilarska","year":"2023","unstructured":"Pilarska E, Kopyt I, Szurowsk E, Rado\u0144-Proskura J, Irga-Jaworska N, Kozera G, Sabiniewicz R, Emich-Widera E, Wojczal J (2023) Polish recommendations for diagnosis and therapy of paediatric stroke. Neurol Neurochir Pol 57(3):243\u2013260","journal-title":"Neurol Neurochir Pol"},{"issue":"15","key":"8296_CR44","doi-asserted-by":"publisher","first-page":"175628642211028","DOI":"10.1177\/17562864221102842","volume":"20","author":"J Philipps","year":"2022","unstructured":"Philipps J, Erdlenbruch B, Kuschnerow M, Jagoda S, Salihaj B, Glahn J, Schellinger PD (2022) Hyperacute treatment of childhood stroke in Lyme neuroborreliosis: report of two cases and systematic review of the literature. Ther Adv Neurol Disord 20(15):17562864221102842. https:\/\/doi.org\/10.1177\/17562864221102842","journal-title":"Ther Adv Neurol Disord"},{"issue":"5","key":"8296_CR45","doi-asserted-by":"publisher","first-page":"e011335","DOI":"10.1161\/JAHA.118.011335","volume":"8","author":"PB Sporns","year":"2019","unstructured":"Sporns PB, Kemmling A, Hanning U, Minnerup J, Str\u00e4ter R, Niederstadt T, Heindel W, Wildgruber M (2019) Thrombectomy in childhood stroke. J Am Heart Assoc 8(5):e011335. https:\/\/doi.org\/10.1161\/JAHA.118.011335","journal-title":"J Am Heart Assoc"},{"issue":"3","key":"8296_CR46","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1007\/s00062-022-01246-y","volume":"33","author":"C Bilgin","year":"2023","unstructured":"Bilgin C, Ibrahim M, Azzam AY, Ghozy S, Elswedy A, Kobeissi H, Sobhi Jabal M, Kadirvel R, Boulouis G, Naggara O, Fiehler J, Psychogios M, Lee S, Wildgruber M, Kemmling A, Al-Mufti F, Kossorotoff M, Sporns PB, Kallmes DF (2023) Mechanical thrombectomy for pediatric large vessel occlusions\u202f: a systematic review and meta-analysis. Clin Neuroradiol 33(3):635\u2013644. https:\/\/doi.org\/10.1007\/s00062-022-01246-y","journal-title":"Clin Neuroradiol"},{"issue":"4","key":"8296_CR47","doi-asserted-by":"publisher","first-page":"e24413","DOI":"10.7759\/cureus.24413","volume":"14","author":"D Rana","year":"2022","unstructured":"Rana D, Chohan M, Hafez N (2022) Atypical case of lyme neuroborreliosis with hyponatremia. Cureus 14(4):e24413. https:\/\/doi.org\/10.7759\/cureus.24413","journal-title":"Cureus"}],"container-title":["Neurological Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-025-08296-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10072-025-08296-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-025-08296-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:56:26Z","timestamp":1756364186000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10072-025-08296-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,19]]},"references-count":47,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["8296"],"URL":"https:\/\/doi.org\/10.1007\/s10072-025-08296-3","relation":{},"ISSN":["1590-1874","1590-3478"],"issn-type":[{"value":"1590-1874","type":"print"},{"value":"1590-3478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,19]]},"assertion":[{"value":"3 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent for the publication of the patient's clinical data and clinical images was obtained from the patient and the patient's parent. A copy of the consent form is available for review by the editors of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}