Abstract
Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory vascular disease. FMD once considered rare, is increasingly a condition recognised as an incidental finding. It is an important cause of stroke especially in younger, female patients and therefore a high index of suspicion is required. FMD has distinct pathological findings along with some pathognomonic angiographic findings (“string of beads” appearance). The mainstay of cerebrovascular FMD treatment is antiplatelet therapy but intervention with percutaneous transluminal angioplasty is indicated under some circumstances. We present an interesting case of a woman in her 60 s who underwent extensive investigation to identify the underlying aetiology of her stroke.
Highlights
Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory vascular disease [1], which has been observed in almost every artery throughout the body, it is more typically associated with renal and carotid arteries [2]
We present a case to illustrate how FMD, not being an uncommon cause of stroke, is significantly under-recognised as a high index of suspicion required to diagnose it
Several studies looking at potential renal donors have found incidental rates between 2% - 6.6% on renal angiogram [3]-[5]
Summary
Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory vascular disease [1], which has been observed in almost every artery throughout the body, it is more typically associated with renal and carotid arteries [2]. The typical renal FMD presentation is hypertension whereas carotid/vertebral FMD has been associated with stroke and TIA. We present a case to illustrate how FMD, not being an uncommon cause of stroke, is significantly under-recognised as a high index of suspicion required to diagnose it. The subsequent discussion will focus on the aetiology, diagnosis and management of carotid and vertebral FMD
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