Fibromuscular dysplasia may herald symptomatic recurrence of cervical artery dissection

Cerebrovasc Dis. 2007;23(5-6):448-52. doi: 10.1159/000101470. Epub 2007 Apr 2.

Abstract

Background: The prevalence of fibromuscular dysplasia (FMD) in patients with cervical artery dissection (CAD) is unknown. Our objectives were to assess the risk of CAD recurring as a stroke or a transient ischemic attack and the association of these events with FMD.

Methods: We prospectively included and followed 103 consecutive patients who had been admitted for a CAD. The median follow-up was 4 years (range 4 months to 10 years). The main criteria for inclusion were a mural hematoma demonstrated by cervical magnetic resonance imaging and/or signs suggesting CAD on 2 other investigations. FMD was diagnosed on the so-called string of beads pattern by digital subtraction angiography.

Results: Five patients had CAD recurrence (60% occurred late). Four of these 5 patients had FMD. In 4 patients, CAD recurrence involved another cervical artery.

Conclusion: The rate of symptomatic CAD recurrence was 1% per year and was often related to FMD.

MeSH terms

  • Adult
  • Angiography, Digital Subtraction
  • Anticoagulants / therapeutic use
  • Carotid Artery, Internal, Dissection / complications*
  • Carotid Artery, Internal, Dissection / drug therapy
  • Carotid Artery, Internal, Dissection / epidemiology
  • Carotid Artery, Internal, Dissection / etiology
  • Carotid Artery, Internal, Dissection / pathology
  • Female
  • Fibromuscular Dysplasia / complications*
  • Fibromuscular Dysplasia / diagnosis
  • Fibromuscular Dysplasia / epidemiology
  • Follow-Up Studies
  • Humans
  • Incidence
  • Ischemic Attack, Transient / epidemiology
  • Ischemic Attack, Transient / etiology*
  • Ischemic Attack, Transient / pathology
  • Magnetic Resonance Angiography
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prognosis
  • Prospective Studies
  • Recovery of Function
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Stroke / epidemiology
  • Stroke / etiology*
  • Stroke / pathology
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Vertebral Artery Dissection / complications*
  • Vertebral Artery Dissection / drug therapy
  • Vertebral Artery Dissection / epidemiology
  • Vertebral Artery Dissection / etiology
  • Vertebral Artery Dissection / pathology

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors