Intracerebral fibromuscular dysplasia (second case of involvement of the posterior cerebral artery)

Abstract

A clinical, angiographic and computed tomographic (CT) scan report on a second case of fibromuscular dysplasia (FMD) of the posterior cerebral artery is presented. A partial infarction of the visual area and upper quadrantanopsia resulted. Angiography of the vertebral artery showed the characteristic ‘string of beads’ with alternating mural dilatation and thinning of the lumen of the right posterior cerebral artery. FMD is an etiologically obscure angiopathy with rare involvement of the intracranial arteries, most frequently found in middle age and in women. The clinical symptoms range from transient ischemic attacks to infarction. Aneurysms and subarachnoid hemorrhages have been observed. The treatment of intracerebral FMD is at present limited to hemodilution, thrombolytic therapy, anticoagula-tion treatment and the prevention of additional risk factors.