Fibromuscular dysplasia in a child: a generalized arterial disease

After slight prodromal symptoms a fourteen-year-old girl had epileptic convulsions followed by a right-sided hemiplegia. Carotid angiogram showed almost total occlusion of the left arteria cerebri media. Six weeks later she developed elevated blood pressure followed by convulsions and lowered consciousness. Abdominal aortic angiogram showed total occlusion of the left renal artery at its origin. After nephrectomy, the blood pressure returned to normal. Histological examination of the main branches of the renal artery revealed fibromuscular dysplastic changes. Renovascular hypertension and childhood idiopathic cerebral arterial disease might represent different aspects of the same process.