Symptomatic Carotid-Bulb Atypical Fibromuscular Dysplasia

Fibromuscular dysplasia (FMD) is known as rare cause ischemic stroke and usually involves the internal carotid or vertebral arteries in middle age women. A poorly known type of FMD located at the carotid bulb is called atypical fibromuscular dysplasia. We present the case of 3 young black patients suffering from recurrent ischemic strokes in the same middle cerebral artery territory. Computed tomographic angiography and arteriography showed a moderate diaphragmatic stenosis of the carotid bulb. After surgical removal of the dysplasia, postoperative course was uneventful without any recurrence. Pathologic examination confirmed atypical FMD. Carotid-bulb atypical FMD is a rare cause of stroke and concerns mostly young black patients. Surgical approach should be recommended to avoid recurrent stroke.