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Multiple Cervical Arteries Dissection Associated With Fibromuscular Dysplasia: A Case Report
Julia Goginski1, Renato Fedatto Beraldo1, Ricardo Nascimento Brito1,2
1Department of Neurosurgery Hospital Universitário Cajuru - PUCPR Curitiba PR Brazil.
Clinical Case Reports
|July 30, 2025
Summary
Fibromuscular dysplasia (FMD) can cause rare, simultaneous dissections in multiple cervical arteries. This case highlights the importance of investigating FMD in patients with complex cerebrovascular events.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Spontaneous cervical artery dissection is frequently linked to connective tissue disorders like fibromuscular dysplasia (FMD).
- FMD is an angiopathy affecting medium-sized arteries, with single-vessel dissection being more common than multi-vessel involvement.
Purpose of the Study:
- To present a rare case of simultaneous dissection of three cervical arteries in a patient with fibromuscular dysplasia.
- To emphasize the diagnostic and management considerations for FMD-associated multi-cervical artery dissection.
Main Methods:
- Case report of a 30-year-old female with bilateral cerebellar infarction, subarachnoid hemorrhage, and hydrocephalus.
- Multimodal imaging including computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA) was utilized.
- Surgical interventions included external ventricular drainage and posterior fossa decompressive craniectomy.
Main Results:
- Imaging confirmed fibromuscular dysplasia with dissections of the right internal carotid artery and both vertebral arteries.
- The patient underwent a two-month course of antiplatelet therapy.
- Minimal residual symptoms were noted, allowing for independent daily activities.
Conclusions:
- Fibromuscular dysplasia is an underrecognized cause of multiple cervical artery dissections.
- Clinicians should maintain a high index of suspicion for FMD in patients presenting with multiple cervical artery dissections.
- Thorough investigation and appropriate management are crucial for similar clinical presentations.
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