Clinical characteristics of fibromuscular dysplasia with severe headache misdiagnosed as cerebral artery dissection: a case report

Abstract

Fibromuscular dysplasia (FMD) is a rare disease with a typical clinical manifestations. This article will describe the clinical features of a FMD case with severe headache misdiagnosed as cerebral artery dissection (CAD). Treatment remedies: we collected the clinical data of a patient with severe headache and performed brain MRI (magnetic resonance imaging) and cerebral arteriovenous MRA (magnetic resonance angiography). The preliminary diagnosis was considered as right vertebral artery dissection, and then cerebral DSA (digital subtraction angiography) was performed for further diagnosis. Post treatment evaluating: cerebral angiography showed that the vessel wall was stiff, with multiple (insect phagocytic)-like changes, and severe stenosis of local long segments. Some vessels showed “double lumen sign”, which was consistent with the performance of FMD. After anticoagulant treatment, the patient’s condition was improved. Conclusions: for severe headache, in addition to common diseases, the possibility of FMD should also be paid great attention. Early cerebrovascular screening is conducive to early diagnosis and timely treatment.

Keywords

arterial dissection / magnetic resonance imaging (MRI) / digital subtraction angiography (DSA) / fibromuscular dysplasia (FMD)