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Fibromuscular dysplasia: an update for the headache clinician
Sarah C O'Connor1, Neil Poria2, Heather L Gornik3
1Cleveland Clinic Lerner, College of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Background:
Fibromuscular dysplasia (FMD) is an uncommon vascular disease that presents with stenosis, aneurysm, dissection, beading, and tortuosity of medium-sized arteries. It primarily manifests in the renal and extracranial carotid and vertebral arteries, and is associated with major vascular events such as carotid artery dissection, renal artery dissection, ruptured aneurysm, transient ischemic attack, stroke, and myocardial infarction (due to coronary artery dissection).
Discussion:
There is a wide spectrum of disease severity among FMD patients. Symptoms of FMD are related to the vascular beds involved and the severity of arterial stenoses. Headache is an extremely common and important symptom reported by patients with FMD, although the precise mechanism of headache in this population is not yet known.
Conclusion:
This review summarizes the most recent literature regarding FMD, including epidemiology, clinical manifestations, imaging practices, and treatment. Special attention will be paid to the association of headaches and FMD. Correct diagnosis, optimal medical management, and appropriate referral for vascular intervention are vital elements of the treatment of patients with FMD. There is a great need for more clinical research regarding the epidemiology, pathophysiology, and optimal treatment of headache in the FMD patient population.
Insights
Fibromuscular dysplasia (FMD) is a rare vascular condition affecting medium-sized arteries, often leading to serious events. Headaches are a common symptom in FMD patients, but their cause requires further research.
Area of Science:
- Vascular Medicine
- Neurology
- Radiology
Background:
- Fibromuscular dysplasia (FMD) is an uncommon vascular disease affecting medium-sized arteries.
- It commonly involves renal and extracranial carotid/vertebral arteries.
- FMD is linked to significant vascular events like stroke and dissection.
Purpose of the Study:
- To review current literature on FMD.
- To focus on the association between FMD and headaches.
- To highlight the need for further research into FMD-related headaches.
Main Methods:
- Literature review of recent studies on FMD.
- Analysis of epidemiological data, clinical manifestations, imaging, and treatment.
- Specific focus on headache presentation in FMD patients.
Main Results:
- FMD presents with diverse severity and symptoms related to affected vascular beds.
- Headaches are a frequent and significant symptom in FMD patients.
- The exact mechanism causing headaches in FMD remains unknown.
Conclusions:
- Accurate diagnosis and management are crucial for FMD patients.
- Optimal medical and interventional strategies are vital.
- More research is needed on the epidemiology, pathophysiology, and treatment of headaches in FMD.
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