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Image of the Month—Diagnosis
Arch Surg. 2003;138:110.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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Answer: Perform Surgical Graduated Dilatation of Stenotic Carotid Artery
Figure 1. Selective angiography of both the right (A) and left (B) internal carotid arteries showing typical "string-of-beads" appearance.
Figure appears in full text version.
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Fibromuscular dysplasia (FMD) of the internal carotid artery (ICA) is a rare condition that may cause transient ischemic attacks, stroke, or even death.1-2 Symptoms produced by FMD are generally secondary to associated arterial stenosis and are clinically indistinguishable from those caused by atherosclerotic disease. Traditionally, the diagnosis of FMD has been by means of conventional selective cerebral angiography performed for evaluation of a suspected carotid stenosis.3-4
Medial fibroplasia (the major subgroup of FMD seen in the ICA) of the extracranial ICA occurs most frequently in women (90%) and is recognized at approximately 55 years of age.5-6 Other vessels commonly involved with the disease process are the renal, vertebral, subclavian, mesenteric, and iliac arteries. Only 10% of patients with FMD will have complications related to this disease. Mainly, symptoms are due . . . [Full Text of this Article]
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