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Implantation of a Carotid Cuff for Triggering Shear-stress Induced Atherosclerosis in Mice
07:51

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Carotid diaphragm: Atypical fibromuscular dysplasia or atheromatous lesions?

D Chaari1, J-M Baud2, L Deschamps3

  • 1Department of neurology and stroke center, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France.

Revue Neurologique
|April 11, 2017
PubMed

Insights

Atypical fibromuscular dysplasia (FMD) can mimic atherosclerosis on imaging, leading to misdiagnosis. Histological and ultrasound findings in two patients revealed atheromatous lesions, not FMD, highlighting the need for diagnostic caution.

Area of Science:

  • Vascular Medicine
  • Neurology
  • Radiology

Background:

  • Atypical fibromuscular dysplasia (FMD) is an underdiagnosed cause of ischemic stroke.
  • A characteristic angiographic pattern of a carotid megabulb septum suggests atypical FMD.

Observation:

  • Two patients presented with a pattern suggestive of atypical FMD.
  • Histological examination revealed atheromatous lesions, not FMD.
  • Contrast-enhanced ultrasound showed enhancement of the spur, inconsistent with FMD.

Findings:

  • The angiographic "septum" was identified as an atheromatous spur.
  • Vascular enhancement on ultrasound indicated active atherosclerosis, not FMD.
  • Histopathology confirmed atheromatous disease in both cases.

Implications:

  • Diagnostic criteria for atypical FMD may require refinement.
  • Stenting procedures for presumed atypical FMD in cervical arteries warrant careful consideration.
  • Accurate differentiation between FMD and atherosclerosis is crucial for appropriate patient management.
Keywords:
AtheromaFibromuscular dysplasiaSeptaeSpurStroke

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