A case is presented in which left-sided hemiparesis-was caused by a fibromuscular dysplasia of the right internal carotid artery in the neck, and is used as a basis for discussion of alae angiographic features.
The 24-year-old woman was admitted to our Department of Neurosurgery, Korea University hospital, with´ the complaints of headache and left-sided hemiparesis which developed abruptly about one month. before this admission. The carotid angiography was performed by puncture of the right common carotid artery under the clinical impression of cerebral thrombosis, which showed no gross intracranial abnormalities. But the charateristic findings were observed under extracranial right internal carotid artery by demonstrating alternating zones of narrowing and widening of the arterial lumen which are so-called loose stocking appearance or `string of beads appearance and are the typical feature of fibromuscular dysplasia.
No surgical interventions such as arterial reconstruction and grafting, or arterial dilatation with bougies were applied on the patient, and she. was discharged from, the hospital three days after the admission.
Fibromuscular dysplasia is a rare sclerotic, noninflammatory lesion of unknown etiology involving the wall of large arteries. This disease is found most frequently in early adult life and women are afflicted more often than men. This condition has been described most often in the renal arteries, where it has, been found to be a cause of hypertension. Among the involvement of carotid system, the cervical portion of the internal carotid artery is most often affected, and the involvements are often bilateral. When localized to the internal carotid arteries, it can give symtoms of intermittent or´ permanent cerebral ischemia, but is usually asymptomatic.
The typical angiographic appearance is the main parameter for diagnosis of fibromuscular dysplasia.
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