Fibromuscular dysplasia dawdling for 8 years before showing its true face

We present a case of acute left-sided carotid dissection associated with contralateral carotid fibromuscular dysplasia and pseudoaneurysm. She had a history of an incidental finding, 8 years earlier, of a right-sided carotid pseudoaneurysm (interpreted as a sequella of an earlier asymptomatic carotid dissection) in the absence of features of fibromuscular dysplasia. This case shows that fibromuscular dysplasia-related pseudoaneurysm/dissection can be seen in the absence of initial radiological fibromuscular dysplasia only occurring many years later during follow-up.