Mironova M, Kortela E, Kurkela S, et al. - In endemic areas, Lyme neuroborreliosis is a rare cause of cerebral vasculitis and stroke, which can easily be missed in routine stroke workup. Hence awareness is necessary concerning Lyme neuroborreliosis–associated vasculitis. All adult patients (>16 years old) diagnosed with borreliosis (A69.2 Lyme borreliosis), transient ischemic attack (TIA, G45), and ischemic stroke (I63) at Helsinki University Hospital from January 1, 2014 to October 31, 2019 were retrospectively identified. Ten cases of neuroborreliosis–associated stroke or TIA and/or vasculitis were identified. Observations suggest a still rare occurrence of Lyme neuroborreliosis–associated vasculopathy and cerebrovascular events, however, it should be considered especially in Lyme borreliosis endemic areas. With appropriate antibiotic and stroke treatment, patients diagnosed with Lyme neuroborreliosis associated stroke seem to have a good prognosis, but there may be a necessity for additional immunosupressive treatment.