[Anterior cerebral artery dissecting aneurysm associated with fibromuscular dysplasia (FMD): a case report]

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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
18:50

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment

Published on: September 25, 2009

K Hatayama1, H Karasawa, H Naito

  • 1Department of Neurosurgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.

No Shinkei Geka. Neurological Surgery
|July 14, 2001
PubMed

Insights

This rare case highlights fibromuscular dysplasia (FMD) causing anterior cerebral artery dissection, leading to stroke and bleeding. Prompt diagnosis and intervention are crucial for managing this complex cerebrovascular condition.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Genetics

Background:

  • Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory vasculopathy.
  • Cerebral artery dissection, particularly of the anterior cerebral artery, is a rare but serious condition.
  • Anterior cerebral artery dissecting aneurysms are uncommon and can lead to severe neurological deficits.

Observation:

  • A 50-year-old woman presented with headache and hemiparesis.
  • Initial angiography revealed A1 segment stenosis and dilatation, progressing to aneurysmal dilatation and double lumen.
  • Subsequent imaging showed aneurysm growth and further stenosis in A2 and A3 segments, complicated by cerebral infarction and subarachnoid hemorrhage.

Findings:

  • Pathological diagnosis confirmed fibromuscular dysplasia (FMD).
  • FMD was identified as the causative factor for both stenosis and the dissecting aneurysm of the anterior cerebral artery.
  • The dissecting aneurysm ultimately ruptured, leading to subarachnoid hemorrhage and cerebral infarction.

Implications:

  • This case underscores the association between FMD and anterior cerebral artery dissecting aneurysms.
  • Early recognition of FMD in patients with cerebrovascular events is critical for appropriate management.
  • Understanding the pathogenesis of FMD-associated aneurysms can inform treatment strategies and improve patient outcomes.

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