Fibromuscular Dysplasia of the Posterior Cerebral Artery: Report of a Case and Review of the Literature

Frens, David B.; Petajan, Jack H.; Anderson, Robert E.; DeBlanc, Harold J.

doi:10.1161/01.str.5.2.161

Cited by 43 publications

(4 citation statements)

References 26 publications

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“…The presence of intracranial aneurysms was reported by Stanley in 41% of patients with internal carotid artery FMD [ 10 ]. Similar results were reported by Frens, who confirmed intracranial aneurysms in 21% of patients referred for angiography due to cervical arterial FMD [ 11 ]. The prevalence of intracranial aneurysm in our group was 14% (1 out of 7).…”

Section: Discussionsupporting

confidence: 89%

Invasive treatment for carotid fibromuscular dysplasia

Tekieli¹,

Maciejewski²,

Dzierwa³

et al. 2015

pwki

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IntroductionFibromuscular dysplasia (FMD) is an infrequent non-inflamatory disease of unknown etiology that affects mainly medium-size arteries. The prevalence of FMD among patients scheduled for endovascular treatment of carotid artery stenosis is unknown.AimTo evaluate the prevalence and treatment options of carotid FMD in patients scheduled for carotid artery stenting (CAS).Material and methodsBetween Jan 2001 and Dec 2013, 2012 CAS procedures were performed in 1809 patients (66.1% men; age 65.3 ±8.4 years, 49.2% symptomatic). In case of FMD suspicion in Doppler-duplex ultrasound (DUS), computed tomography angiography was performed for aortic arch and extracranial and intracranial artery imaging. For invasive treatment of FMD carotid stenosis, balloon angioplasty was considered first. If the result of balloon angioplasty was not satisfactory (> 30% residual stenosis, dissection), stent placement was scheduled. All patients underwent follow-up DUS and neurological examination 3, 6 and 12 months after angioplasty, then annually.ResultsThere were 7 (0.4%) (4 symptomatic) cases of FMD. The FMD group was younger (47.9 ±7.5 years vs. 67.2 ±8.9 years, p = 0.0001), with higher prevalence of women (71.4% vs. 32.7%, p = 0.0422), a higher rate of dissected lesions (57.1% vs. 4.6%, p = 0.0002) and less severe stenosis (73.4% vs. 83.9%, p = 0.0070) as compared to the non-FMD group. In the non-FMD group the prevalence of coronary artery disease was higher (65.1% vs. 14.3% in FMD group, p = 0.009). All FMD patients underwent successful carotid artery angioplasty with the use of neuroprotection devices. In 4 cases angioplasty was supported by stent implantation.ConclusionsFibromuscular dysplasia is rare among patients referred for CAS. In case of significant FMD carotid stenosis, it may be treated with balloon angioplasty (stent supported if necessary) with optimal immediate and long-term results.

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Section: Discussionsupporting

confidence: 89%

Invasive treatment for carotid fibromuscular dysplasia

Tekieli¹,

Maciejewski²,

Dzierwa³

et al. 2015

pwki

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“…Intracranial FMD is rare, with only sporadic cases reported in the literature. 6 " 16 In many of these reported cases FMD was limited to the intrapetrosal internal carotid artery or involved only the carotid siphon. Hence, true intradural intracranial FMD is distinctly uncommon.…”

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confidence: 99%

Angiographic spectrum of cervical and intracranial fibromuscular dysplasia.

Osborn¹,

Anderson²

1977

Stroke

208

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SUMMARY Cephalocervical or intracranial fibromuscular dysplasia (FMO) can be identified by its characteristic angiographic appearance. Most of these lesions occur adjacent to the Cl-2 interspace, characteristically sparing the origins and proximal segments of the major extracranial vessels. Approximately 65% of our patients had bilateral involvement of the cervical internal carotid arteries. Thirty percent were associated with one or more intracranial aneurysms. The vertebral arteries were involved in 10% of the cases. Twenty-four of 25 cases were associated with symptoms of either subarachnoid hemorrhage or focal cerebral ischemia.

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“…Another case of a 19-year-old female with FMD of the proximal segments of the left MCA and ACA presented with left-sided headache, polyphagia, hypersomnia, truancy, visual hallucinations, right central facial weakness, and left-sided ptosis [ 11 ]. A 28-year-old male presented with headache, right-sided numbness and weakness, diminished right-sided vision, and aphasia with angiographic evidence of isolated left proximal posterior cerebral artery [ 12 ]. A 24-year-old woman with a chief complaint of loss of right-sided vision and left posterior headache was found to have isolated left posterior cerebral artery FMD [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Isolated Intracranial Fibromuscular Dysplasia

McDonald

2020

Cureus

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Fibromuscular dysplasia (FMD) is a non-inflammatory, non-atherosclerotic disease resulting in stenosis and arterial wall weakening of typically medium-sized arteries. Intracranial aneurysm is an uncommon presentation of FMD, with a significant proportion presenting in the posterior circulation. Presented is the rare case of an adult female with left-sided stroke with angiographically-confirmed left middle cerebral artery FMD, with pan-scanning unremarkable for other demonstrable evidence of FMD. The patient’s neurological deficits completely resolved. The patient was stable for discharge home on antiplatelet therapy. Appropriate imaging and screening should be performed to ensure FMD is localized versus systemic. Patients with intracranial FMD should be protected from cerebrovascular events with antiplatelet therapy.

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Fibromuscular Dysplasia of the Posterior Cerebral Artery: Report of a Case and Review of the Literature

Cited by 43 publications

References 26 publications

Invasive treatment for carotid fibromuscular dysplasia

Invasive treatment for carotid fibromuscular dysplasia

Angiographic spectrum of cervical and intracranial fibromuscular dysplasia.

A Case of Isolated Intracranial Fibromuscular Dysplasia

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