Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Bilateral internal carotid artery occlusion and severe basilar artery stenosis in a patient with fibromuscular dysplasia: a case report

Shunichi Yoshida, M.D.1), Kaoru Eguchi, M.D.2) , Kazunari Onodera, M.D.1), Kengo Suzuki, M.D.1), Kenichiro Fujishiro, M.D.1) and Shigeo Riku, M.D.1)

1)Department of Neurology, Social Insurance Chukyo Hospital
2)Department of Neurosurgery, Social Insurance Chukyo Hospital

Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory arterial disease of unknown etiology. We report a 26-year-old woman who presented with transient ischemic attack (TIA) due to bilateral internal carotid artery (ICA) occlusion and severe basilar artery stenosis, as FMD was diagnosed by a biopsy specimen of right ICA. Imaging investigations included magnetic resonance angiography and catheter angiogram without characteristic "string of beads" pattern, before reaching a definitive diagnosis by pathologist. Anti-platelet therapy and bypass surgery of superficial temporal artery-middle cerebral artery revealed no more clinical symptoms. This case of intra- and extra-cranial FMD gives a consideration of such rare disease in the differential diagnosis of TIA or stroke in healthy young patients. The literature of FMD is reviewed including pathological findings.
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(CLINICA NEUROL, 53: 439|445, 2013)
key words: fibromuscular dysplasia, bilateral internal carotid artery occlusion, basilar artery stenosis, transient ischemic attack

(Received: 17-Sep-12)