Fibromuscular Dysplasia and Its Neurologic Manifestations

Abstract

had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis".

Management of hypertension in pregnancy — prevention, diagnosis, treatment and long-term prognosis. A position statement of the Polish Society of Hypertension, Polish Cardiac Society and Polish Society of Gynaecologists and Obstetricians

“…Renal artery dissection may have detrimental clinical consequences, leading to the sudden onset of severe, refractory or malignant HT, acute kidney injury and renal infarction. Dissection of other arteries, including coronary, carotid and vertebral arteries, is also possible in patients with FMD [137][138][139][140][141]. The risk of PE in women with FMD is probably higher than in women without FMD, however, this data comes from one study in a small sample [142].…”

The European/International Fibromuscular Dysplasia Registry and Initiative (FEIRI)—clinical phenotypes and their predictors based on a cohort of 1000 patients

“…Renal FMD may lead to hypertension, while cerebrovascular involvement may result in headache, pulsatile tinnitus, transient ischaemic attack, stroke and/or subarachnoid haemorrhage. 2,4 The US 5 and French 6 FMD registries have substantially improved our knowledge on the demographic characteristics, classification, prevalence, and clinical manifestations of FMD. Thanks to their joint efforts, along with those of other groups around the world, our conception of FMD has evolved from a rare cause of renovascular hypertension of young women to a systemic vascular disease which may be diagnosed at all ages, both in women and men with a wide range of manifestations.…”

Spontaneous Bilateral Carotid Artery Dissection Revealing Multifocal Fibromuscular Dysplasia

“…In the case of Longitudinal studies of patients with cerebrovascular FMD reported a risk of TIA or ischemic stroke during follow-up between 0.6% and 3.7% per year and a risk of intracerebral hemorrhage of less than 1% per year [5]. In the absence of stroke complications, the prognosis of isolated cerebrovascular FMD remains favorable [12]. Our observation is particularly interesting at several levels.…”

“…The typical angiographic aspect of a multifocal FMD is the "string of beads" one resulting from the alternation of stenosis with aneurismal dilatation, which is the most common aspect, found in 90% of cases. This aspect generally affects the medial and distal portions of the internal carotid artery and the V3-V4 segment of the vertebral arteries at the C1 and C2 vertebrae, areas usually unaffected by atherosclerosis [12]. In monofocal FMD, unifocal concentric (<1 cm in length) or tubular (≥1 cm) smooth narrowing can occur in any portion of the artery [12] [13].…”

“…The management of ischemic stroke secondary to FMD is similar to that of patients without FMD. In the acute phase, intravenous thrombolysis and/or mechanical thrombectomy are indicated; an antithrombotic agent must be prescribed later [12]. In the case of Longitudinal studies of patients with cerebrovascular FMD reported a risk of TIA or ischemic stroke during follow-up between 0.6% and 3.7% per year and a risk of intracerebral hemorrhage of less than 1% per year [5].…”