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A Case of Isolated Intracranial Fibromuscular Dysplasia
1Internal Medicine, Hospital Corporation of America Healthcare in Association with the University of South Florida Morsani College of Medicine Graduate Medical Education Programs, Northside Hospital, St. Petersburg, USA.
Abstract:
Fibromuscular dysplasia (FMD) is a non-inflammatory, non-atherosclerotic disease resulting in stenosis and arterial wall weakening of typically medium-sized arteries. Intracranial aneurysm is an uncommon presentation of FMD, with a significant proportion presenting in the posterior circulation. Presented is the rare case of an adult female with left-sided stroke with angiographically-confirmed left middle cerebral artery FMD, with pan-scanning unremarkable for other demonstrable evidence of FMD. The patient's neurological deficits completely resolved. The patient was stable for discharge home on antiplatelet therapy. Appropriate imaging and screening should be performed to ensure FMD is localized versus systemic. Patients with intracranial FMD should be protected from cerebrovascular events with antiplatelet therapy.
Insights
Fibromuscular dysplasia (FMD) can cause stroke, even when localized to a single artery like the middle cerebral artery. Early diagnosis and antiplatelet therapy are crucial for recovery and preventing future cerebrovascular events.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Fibromuscular dysplasia (FMD) is a non-atherosclerotic arterial disease affecting medium-sized arteries.
- Intracranial involvement, though uncommon, can manifest as stenosis or aneurysms, particularly in the posterior circulation.
Observation:
- A rare case of an adult female presenting with a left-sided stroke.
- Angiography confirmed FMD localized to the left middle cerebral artery.
- Systemic FMD was ruled out by comprehensive imaging.
Findings:
- The patient experienced complete resolution of neurological deficits.
- The localized FMD was successfully managed with antiplatelet therapy.
- The patient was discharged in stable condition.
Implications:
- Highlights the importance of thorough imaging to differentiate localized versus systemic FMD.
- Emphasizes the role of antiplatelet therapy in preventing cerebrovascular events in patients with intracranial FMD.
- Suggests that prompt diagnosis and management can lead to favorable outcomes in stroke secondary to FMD.
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