Presentation
The most accurate diagnosis comes from combining clinical presentation and angiographic imaging. [en.wikipedia.org]
These changes were not present on the previous angiogram. [cureus.com]
We present a case where long stenoses of both internal carotid arteries were associated with terminal carotid occlusions and a ruptured basilar aneurysm. [ncbi.nlm.nih.gov]
By comparison, this patient did not present with an active herpetic infection, and no evidence was present of an inflammatory response. [ispub.com]
Typical angiographic findings ofdissection of the renal artery are presented in Fig 1, andoperative findings are shown in Fig 2. [docslide.com.br]
Entire Body System
- Pain
Cervical bruit Visceral FMD : Chronic mesenteric ischemia : postprandial abdominal pain, epigastric bruit, weight loss Acute mesenteric ischemia : nausea, vomiting, abdominal pain, bloody diarrhea Splenic infarction : LUQ abdominal pain, fever, nausea [amboss.com]
Severe stenosis can cause pain in the area of the body that is supplied by the affected artery. [healthcommunities.com]
Any pain or clinical sign related to FMD typically comes from the organ that is supplied by that artery. For example, FMD in the renal arteries may cause high blood pressure. FMD in the carotid arteries may cause headaches or pulsatile tinnitus. [raredr.com]
[…] may experience: Abdominal pain after eating Unintended weight loss If it is in the arteries leading to your heart, you may have chest pain or, less often, a heart attack. [mountsinai.org]
Funny how a bypass can take care of years of living with severe pain!” “I've always had chronic chest pain...very athletic when "younger" ...running many miles, training for marathon, etc. One day, chest pain was really bad (I fell into bleachers)! [fmdchat.blogspot.com]
Cardiovascular
- Thrombosis
They cause symptoms from thrombosis, embolisation or compression of adjacent structures, causing venous thrombosis or neuropathy. Femoral aneurysms These are the second most common peripheral aneurysm. [patient.info]
Acute Deep Venous Thrombosis: Pathophysiology and Natural History 50. Acute Deep Thrombosis: Clinical and Diagnostic Evaluation 51. Acute Deep Venous Thrombosis: Prevention and Medical Management 52. [euro-libris.ro]
Sinus thrombosis Sinus thrombosis is clotting of the dural venous sinuses, major veins in the lining of the brain. They drain blood from the brain back to the heart. Sinus thrombosis occurs when the blood within the vein clots and blocks the vein. [med.stanford.edu]
Doppler ultrasound of the carotid arteries showed intraluminal thrombosis partially occluding the flow of blood at the level of the left common carotid bulb. [article.sapub.org]
Prevention of thrombosis of affected arteries may be taken through administration of an antiplatelet medication such as aspirin. Percutaneous transluminal renal angioplasty (PTRA) remains the gold standard for renal-artery FMD. [en.wikipedia.org]
- Carotid Bruit
Causes of Amaurosis Fugax The presence of a bruit, and the unilateral nature and duration of the visual loss, are indicative of an embolic etiology from a carotid stenosis, most likely from bifurcation disease. [thoracickey.com]
Examination may reveal neurological deficits, Horner's syndrome (half of cases), hemiparesis, carotid bruit. [patient.info]
No audible carotid bruit was heard. However, a grade 2/6 systolic murmur was prominent at the left costal margin. Cranial nerves II through XII were intact bilaterally. [ispub.com]
Musculoskeletal
- Muscle Weakness
Carotid arteries: Transient ischemic attack or stroke symptoms (such as trouble speaking, muscle weakness, paralysis on one side of the body, vision problems) Intracranial arteries: Symptoms of an aneurysm (such as headaches, pain above and behind the [merckmanuals.com]
Neurologic
- Stroke
Gain fresh perspectives and up-to-date insights from the world’s leading authorities on the pathophysiology, diagnosis, and management of stroke. [books.google.de]
Also it was the cover story in the March/April issue of Stroke Connection, a publication of the American Stroke Association (ASA). [strokenetwork.org]
A TIA is a warning sign that you may develop a stroke. If your symptoms last longer than 24 hours, you may have experienced a stroke. [vascularpavilion.com]
These actions might prevent a future stroke. Although a mini-stroke may warn of a stroke, it doesn’t predict when a stroke will happen. A stroke may occur days, weeks, or even months after a mini-stroke. [surgery.ucsf.edu]
- Slurred Speech
TIA symptoms can last for a few minutes or as long as an hour and include: Sudden weakness, numbness or tingling on one side of the face or body, or in a single limb Difficulty speaking or slurred speech Change in vision, such as losing all or partial [inovaheart.org]
I had slurred speech and left side weakness. This is unusual unless your speech is on the right side of your brain, which only 10 percent of the population has. [fmdchat.blogspot.com]
Upon arrival to the ED, the patient exhibited right-sided weakness and slurred speech. [ispub.com]
- Dysesthesia
Facial numbness and dysesthesia. New features of carotid artery dissection. Arch Neurol. 1987 Mar;44(3):345–346. [PubMed] [Google Scholar] Houser OW, Mokri B, Sundt TM, Jr, Baker HL, Jr, Reese DF. [ncbi.nlm.nih.gov]
Workup
Further workup was done to confirm the diagnosis of FMD, and magnetic resonance angiography of the carotid arteries revealed a “string of beads” appearance in the right internal carotid artery, which confirmed the diagnosis of FMD. [cureus.com]
See Workup for more detail. Management Partly because of the unknown etiology of FMD, no curative therapy exists. Fortunately, FMD is often benign when asymptomatic, and medical treatment is not indicated. [emedicine.medscape.com]
[…] are located more distally and extend into the distalbranches or parenchyma of the kidney.In this retrospective study we summarize experiencefrom a referral center for complicated renal vascular disease.Included are clinical presentation, diagnostic workup [docslide.com.br]
Treatment
Access the comprehensive, expert clinical guidance you need to recognize the clinical manifestations of stroke, use the latest laboratory and imaging studies to arrive at a diagnosis, and generate an effective medical and surgical treatment plan. [books.google.de]
These lesions require careful planning for treatment. [med.stanford.edu]
Abdominal-Pelvic Venous Disease: Surgical Treatment 62. Abdominal-Pelvic Venous Disease: Endovascular Treatment 63. Superior Vena Cava Obstruction: Surgical Treatment 64. Superior Vena Cava Occlusion: Endovascular Treatment 65. [euro-libris.ro]
[…] together with the treatment of hypertension. [cdt.amegroups.com]
In another series of 70 patients undergoing treatment for FMD of the cerebral circulation, the mean age at presentation was 62 years. 4 Treatment options for FMD of the renal arteries include medical therapy alone or revascularization by either percutaneous [vasculardiseasemanagement.com]
Prognosis
Prognosis [ edit ] Prognosis and outcome research is scant. In some cases if not managed properly FMD-related aneurysms can occur causing bleeding into the brain, resulting in stroke, permanent nerve damage, or death. [en.wikipedia.org]
[…] allows assessment of end-organ ischemic damage. typical angiographic features include: vascular loops, fusiform vascular ectasia and a string of beads less typical features include: arterial dissection, aneurysm and subarachnoid hemorrhage Treatment and prognosis [radiopaedia.org]
Although the pathophysiology of FMD)is not known, smoking has been implicated as a potential contributing factor and portends a worse prognosis. [emedicine.medscape.com]
[…] in their 50 s (mean age 51.9 years) for arteries supplying the head and neck, heart, kidneys, and pelvis to prevent catastrophic complications because FMD is autosomal dominant. [5], [6] This case demonstrates that such patients may have a favorable prognosis [indjvascsurg.org]
Because the overall long-term prognosis of fibro muscular dysplasia of the cervico-cephalic arteries is quite good and this patient does not present any other downstream adverse vascular events, conservative treatment with periodical follow-up was given [omicsonline.org]
Etiology
Fibromuscular Dysplasia Fibromuscular Hyperplasia, FMH Submitted by Ab Shrivastava, MD General Considerations Incidence 0.6% via angiography 1.1% via autopsy Female to male ratio 3:1 Presenting age 25-50 Pathology Developmental lesion of unknown etiology [learningradiology.com]
FMD was suspected as an underlying etiology of SCAD in this young female with no traditional risk factors for atherosclerotic disease. [cureus.com]
Its etiology is unknown. The arteries other than renal and carotid to be involved are vertebral, lumbar, mesenteric, celiac, hepatic and iliac arteries. [sonoworld.com]
Although the etiology of FMD is unknown, several other associated vascular pathologies have been identified. [emedicine.medscape.com]
The differential diagnosis of amaurosis fugax is extensive and can be divided into circulatory, ocular, and neurologic etiologies (Table 1 ). [thoracickey.com]
Epidemiology
Epidemiology Age of onset : typically 30–50 years ;, but can manifest at any age Sex : ♀ > ♂ ( 8:1 ) Ethnicity : increased prevalence among the white population References: [1] [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified [amboss.com]
Hopefully, we will be able to better understand the epidemiology of the disease, clinical characteristics, and management. [cathlabdigest.com]
Although the multiple manifestations of a structural arteriopathy in FMD hint of a genetic cause, such as collagen or elastin mutation, epidemiologic data suggesting familial transmission are generally weak. [emedicine.medscape.com]
[…] vascular bed involvement, vascular procedures, and clinical outcomes of patients with FMD. 8,9 Table 1 highlights key findings and lessons learned from registry publications, many of which have altered previous concepts of this disease. 3,7,8,10–12 EPIDEMIOLOGY [mdedge.com]
Epidemiology and Clinical Analysis 2. Embryology 3. Vessel Wall Biology 4. Cells of the Vascular System 5. Atherosclerosis 6. Intimal Hyperplasia 7. Ischemia-Reperfusion 8. Arteriogenesis and Angiogenesis 9. [euro-libris.ro]
Pathophysiology
Gain fresh perspectives and up-to-date insights from the world’s leading authorities on the pathophysiology, diagnosis, and management of stroke. [books.google.de]
Pathophysiology Fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory, non-atherosclerotic, developmental condition that primarily affects small and medium-sized muscular arteries. [amboss.com]
Although the pathophysiology of FMD)is not known, smoking has been implicated as a potential contributing factor and portends a worse prognosis. [emedicine.medscape.com]
Arterial Aneurysms Section 2: Pathophysiology 10. Arterial Physiology 11. Venous Physiology 12. Venous Pathology 13. Lymphatic Pathophysiology Section 3: Clinical and Vascular Laboratory Evaluation 14. Patient Clinical Evaluation 15. [euro-libris.ro]
[…] involvement, vascular procedures, and clinical outcomes of patients with FMD. 8,9 Table 1 highlights key findings and lessons learned from registry publications, many of which have altered previous concepts of this disease. 3,7,8,10–12 EPIDEMIOLOGY AND PATHOPHYSIOLOGY [mdedge.com]
Prevention
Stay up to date on hot topics such as mechanisms of action of commonly used drugs, neuronal angiogenesis and stem cells, basic mechanisms of spasm and hemorrhage, prevention of stroke, genetics/predisposing risk factors, and much more. [books.google.de]
Segmental resection and autogenous graft reconstruction of the carotid artery were successful in removing the lesion and preventing subsequent symptoms. [ncbi.nlm.nih.gov]
These measures were expected to provide excellent long-term patency and help prevent strokes in the future. [indjvascsurg.org]
HDL is the “good” cholesterol that helps prevent coronary heart disease. [surgery.ucsf.edu]
Your doctor may prescribe medications to prevent your blood from clotting and to help prevent a stroke. [vascularpavilion.com]