Internal carotid artery dissection, cerebral aneurysms and thin basement membrane nephropathy

Abstract

JO N 2871 A previously well, 52-year-old woman presented after one week of headache, nausea and difficulty speaking. She had a history of hypertension treated with metoprolol and painless microscopic hematuria. There was no family history of hematuria or renal disease. Renal ultrasound and cystoscopy were normal, and a renal biopsy one year before presentation showed thin glomerular basement membrane nephropathy (TBMN, Fig. 1C). Examination revealed an expressive dysphasia and a right homonymous hemianopia. Blood pressure was 140/76; there were no overt clinical features suggestive of a connective tissue disorder. MRI and MR angiography showed a Nicholas J. Cutfield John L. Wilson L. Jonathan Zwi Barry J. Snow