Fibromuscular dysplasia (FMD) is an angiopathy that commonly affects the renal arteries but may affect other medium to large arteries, including the carotid artery. It has a variety of angiographic appearances, the most common of which is a string-of-beads pattern consisting of a segment of alternating stenoses and dilatations. This case documents that these patterns are not necessarily fixed. An initial angiogram in a patient with neurologic symptoms shows a string-of-beads pattern in the carotid artery. Later, this pattern is seen to convert to a smooth tubular form on follow-up arteriography. FMD may present angio graphically as a dynamic process.
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References
1.
Mettinger KL : Fibromuscular dysplasia and the brain II. Current concept of the disease. Stroke13:53-58, 1982.
2.
Ledbetter WF , Burkland CE: Hypertension in the unilateral renal disease . J Urol (Baltimore) 39:611-625, 1983.
3.
Appleberg M. : Graduated internal dilatation in the treatment of fibromuscular dysplasia of the internal carotid artery. S Afr Med J51:244-261, 1977.
4.
Palubinskas AJ, Newton TL: Fibromuscular hyperplasia of the internal carotid arteries. Radiol Clin Biol34:365-370, 1965.
5.
Bragin MA, Cherkasov AP: Morphogenesis of fibromuscular dysplasia of the renal arteries. An ultrastructural study. Arkh Patol41:46-52, 1979.
6.
Stanley JC, Gewertz BL, Bore EL, et al: Arterial fibrodysplasia. Histopathologic character and current etiologic concepts. Arch Surg110:561-566, 1975.
7.
Osborn AG, Anderson RE: Angiographic spectrum of cervical and intracranial fibromuscular dysplasia . Stroke8:617-626, 1977.
8.
Houser OW, Baker HL Jr: Fibromuscular dysplasia and other uncommon diseases of the cervical carotid artery: Angiographic aspects. Am J Roentgenol104:201-212, 1968.
Kaufman HH: Fibromuscular hyperplasia of the carotid artery in a case associated with arteriovenous malformation. Arch Neurol22:299-304, 1970.
11.
Galligioni F., Iraci G., Marin G.: Fibromuscular hyperplasia of the extracranial internal carotid artery. J Neurosurg34:647-651, 1971.
12.
Hooshmand H. , Boykin ME, et al: Fibromuscular dysplasia of the extracranial internal carotid arteries associated with an ulcerative plaque. Stroke3:67-70, 1972.
13.
Chiras J., Bories J., Barth MO, et al: Cerebral angiography in ischemic strokes. Neuroradiology27:521-538, 1985.
14.
Heiserman JE , Drayer DP, Fram EK, et al: MR angiography of cervical fibromuscular dysplasia. Am J Neuroradiol13:1454-1457, 1992.
15.
Smullens SN : Surgically treatable lesions of the extracranial circulation, including the vertebral artery. Radiol Clin North Am24:453-460, 1986.
16.
Bellot J., Gherardi R., Poirier J., et al: Fibromuscular dysplasia of cervico-cephalic arteries with multiple dissections and a carotid-cavernous fistula. A pathological study. Stroke16:255-261, 1985.
