Renovascular hypertension and demyelimating disease in a young woman

Renal artery stenosis is an uncommon, but curable cause of systemic hypertension. The most common causes of stenosis are atherosclerosis, and fibromuscular dysplasia. Diagnosis may be difficult due to the lack of a suitable screening test, and a high index of suspicion needs to be maintained. Treatment may be with pharmacotherapy, renal angioplasty, or surgery and the choice of therapy needs to be tailored to the individual patient. Once a stenotic lesion is discovered in a hypertensive patient, the functional significance is not always clear cut. Fibromuscular dysplasia may be a systemic disease in some cases, and may affect the central nervous system.