Cerebral embolism from septal fibromuscular dysplasia of the common carotid artery

Abstract

A rare type of fibromuscular dysplasia of the common carotid artery, in the form of a septum, was observed in a patient suffering from recurrent cerebral infarctions. Angiography demonstrated growth of the lesion and documented the presence of an intraluminal thrombus attached to it. Comparison with reported cases of the more common "string of beads" lesion of fibromuscular dysplasia suggests that the risk for development of ischemic neurological problems is higher for this type of fibromuscular lesion. Surgical correction is recommended, especially for symptomatic patients.

Carotid Webs and Recurrent Ischemic Strokes in the Era of CT Angiography

“…Fibrous intimal thickening noted in our specimens may be a feature of the intimal variant of fibromuscular dysplasia in the internal carotid artery. 12,13,15,16 The intimal shelf observed in 1 of our patients has been previously described as an intimal variant of FMD. 16 It is also possible that the various forms of asymmetric fibrous intimal cushions observed in the other 3 patients in our study represent part of the spectrum of intimal FMD in the internal carotid artery.…”

“…5,7 With a few exceptions, 5,7-10 previous reports of carotid web descriptions relied on conventional angiography. 1,3,[11][12][13][14][15] The MRA appearance of the carotid web is expected to be similar to that on CTA, though this needs to be studied. Endarterectomy performed for atherosclerotic carotid stenosis typically produces a specimen with a classic atheroma, characterized by a large necrotic lipid-rich core covered by a fibrous cap.…”

Carotid-Bulb Atypical Fibromuscular Dysplasia in Young Afro-Caribbean Patients With Stroke

“…CTA anomalies may also be subtle or confused with plaque. However, some images evoked CaFMD: a thin 2,6,7 or thick 8 spur, located on the posterolateral side of the bulb, megabulb appearance 2 and no carotid calcification. Moreover, the absence of vascular risk factors in 68% of our young patients is not suggestive of atherosclerosis.…”

“…2 Curiously, all but one 5 report on CaFMD are not recent, which might explain our suboptimal knowledge about this cause of stroke affecting the young and potentially recurrent. 6,7 Because Martinique, a French West Indies island, is inhabited mostly by Afro-Caribbeans, we expected to find CaFMD responsible for ischemic strokes in young Martinicans. Therefore, we systematically sought CaFMD in young patients with stroke.…”

Riles Type 1A Common Carotid Artery Occlusion Diagnosed by Specific External Carotid Artery Doppler Waveform Pattern in Carotid Ultrasonography -Case Report-

“…13) CCA occlusion is mainly due to atherosclerosis, but other etiologies, such as arteritis, fibromuscular dysplasia, trauma, and radiation, have also been reported. 7,11,15,17) The site of the origin and the direction of propagation of CCA occlusion are controversial. CCA occlusion may begin at the carotid bifurcation and propagate proximally, 9) or may begin at the CCA origin and propagate antegradely.…”