eMedicine Specialties > Neurology > Neuro-vascular Diseases

Fibromuscular Dysplasia: Multimedia

Author: James A Wilson, MD, MSc, FRCPC, BSc(H), Neurologist and Clinical Neurophysiologist, Oconee Neurology Services
Coauthor(s): Richard L Hughes, MD, Associate Professor, Department of Neurology, University of Colorado School of Medicine; Director, University of Colorado Affiliated Hospitals Stroke Project; Chief, Division of Neurology, Denver Health Medical Center
Contributor Information and Disclosures

Updated: Aug 30, 2007

Multimedia

Fibromuscular dysplasia (FMD). Digital subtractio...
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Media file 1: Fibromuscular dysplasia (FMD). Digital subtraction angiogram of the right internal carotid artery demonstrates an irregular extracranial portion that is consistent with FMD.
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Fibromuscular dysplasia (FMD). Digital subtractio...

Fibromuscular dysplasia (FMD). Digital subtraction angiogram of the right internal carotid artery demonstrates an irregular extracranial portion that is consistent with FMD.

Fibromuscular dysplasia (FMD). Conventional angio...
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Media file 2: Fibromuscular dysplasia (FMD). Conventional angiogram of the left carotid artery demonstrates a 1.5-cm, long, smooth, severe stenosis of the extracranial internal carotid artery. Note that the artery is not completely occluded and a thin continuous string of contrast is present along the length of the stenosis. This smooth tubular stenosis is suggestive of the intimal fibroplasia form of FMD but can be observed with any of the subtypes.
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Fibromuscular dysplasia (FMD). Conventional angio...

Fibromuscular dysplasia (FMD). Conventional angiogram of the left carotid artery demonstrates a 1.5-cm, long, smooth, severe stenosis of the extracranial internal carotid artery. Note that the artery is not completely occluded and a thin continuous string of contrast is present along the length of the stenosis. This smooth tubular stenosis is suggestive of the intimal fibroplasia form of FMD but can be observed with any of the subtypes.

Fibromuscular dysplasia (FMD). Cerebral angiogram...
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Media file 3: Fibromuscular dysplasia (FMD). Cerebral angiogram of the left carotid artery territory demonstrates a long, irregular stenosis with a string-of-beads appearance along the entire extracranial length of the internal carotid artery (ICA). This is consistent with the most common medial dysplasia form of fibromuscular dysplasia. Also note similar involvement of the first 3 cm of the external carotid artery (ECA). Such extensive ICA involvement, as well as ECA involvement, is atypical. Note sparing of the carotid bulb.
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Fibromuscular dysplasia (FMD). Cerebral angiogram...

Fibromuscular dysplasia (FMD). Cerebral angiogram of the left carotid artery territory demonstrates a long, irregular stenosis with a string-of-beads appearance along the entire extracranial length of the internal carotid artery (ICA). This is consistent with the most common medial dysplasia form of fibromuscular dysplasia. Also note similar involvement of the first 3 cm of the external carotid artery (ECA). Such extensive ICA involvement, as well as ECA involvement, is atypical. Note sparing of the carotid bulb.

Fibromuscular dysplasia (FMD). Lateral view of a ...
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Media file 4: Fibromuscular dysplasia (FMD). Lateral view of a right carotid angiogram demonstrates multiple stenoses of FMD of the internal carotid artery. The string of beads appearance is suggestive of the medial dysplasia form of FMD.
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Fibromuscular dysplasia (FMD). Lateral view of a ...

Fibromuscular dysplasia (FMD). Lateral view of a right carotid angiogram demonstrates multiple stenoses of FMD of the internal carotid artery. The string of beads appearance is suggestive of the medial dysplasia form of FMD.

Fibromuscular dysplasia (FMD). Anteroposterior vi...
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Media file 5: Fibromuscular dysplasia (FMD). Anteroposterior view of a right carotid angiogram demonstrates FMD of the extracranial portion of the right internal carotid artery.
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Fibromuscular dysplasia (FMD). Anteroposterior vi...

Fibromuscular dysplasia (FMD). Anteroposterior view of a right carotid angiogram demonstrates FMD of the extracranial portion of the right internal carotid artery.

Fibromuscular dysplasia (FMD). Angiogram of the d...
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Media file 6: Fibromuscular dysplasia (FMD). Angiogram of the descending aorta demonstrates the stenoses of FMD in the renal arteries bilaterally.
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Fibromuscular dysplasia (FMD). Angiogram of the d...

Fibromuscular dysplasia (FMD). Angiogram of the descending aorta demonstrates the stenoses of FMD in the renal arteries bilaterally.

Fibromuscular dysplasia (FMD). Angiogram of the r...
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Media file 7: Fibromuscular dysplasia (FMD). Angiogram of the right vertebral artery demonstrating irregular stenoses of fibromuscular dysplasia at the level of C2-3.
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Fibromuscular dysplasia (FMD). Angiogram of the r...

Fibromuscular dysplasia (FMD). Angiogram of the right vertebral artery demonstrating irregular stenoses of fibromuscular dysplasia at the level of C2-3.

Fibromuscular dysplasia (FMD). Cartoon illustrate...
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Media file 8: Fibromuscular dysplasia (FMD). Cartoon illustrates the operative approach of graduated dilatation of the internal carotid artery (ICA). The common carotid and external carotid arteries are cross-clamped, and the superior thyroid artery is clipped while the ICA is isolated, opened, and dilated with progressively larger dilators. This technique has been shown to be successful in the management of medically refractive FMD stenoses.
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Fibromuscular dysplasia (FMD). Cartoon illustrate...

Fibromuscular dysplasia (FMD). Cartoon illustrates the operative approach of graduated dilatation of the internal carotid artery (ICA). The common carotid and external carotid arteries are cross-clamped, and the superior thyroid artery is clipped while the ICA is isolated, opened, and dilated with progressively larger dilators. This technique has been shown to be successful in the management of medically refractive FMD stenoses.

Fibromuscular dysplasia (FMD). Illustration depic...
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Media file 9: Fibromuscular dysplasia (FMD). Illustration depicts the intraluminal appearance of graduated dilatation of the stenoses of FMD. The dilator is passed into the vessel and opens the bandlike narrowings.
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Fibromuscular dysplasia (FMD). Illustration depic...

Fibromuscular dysplasia (FMD). Illustration depicts the intraluminal appearance of graduated dilatation of the stenoses of FMD. The dilator is passed into the vessel and opens the bandlike narrowings.

Fibromuscular dysplasia (FMD). Illustration depic...
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Media file 10: Fibromuscular dysplasia (FMD). Illustration depicts the locations of FMD lesions, which differentiate regions with typical and atypical angiographic appearances of this disease.
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Fibromuscular dysplasia (FMD). Illustration depic...

Fibromuscular dysplasia (FMD). Illustration depicts the locations of FMD lesions, which differentiate regions with typical and atypical angiographic appearances of this disease.

Fibromuscular dysplasia (FMD). Digital subtractio...
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Media file 11: Fibromuscular dysplasia (FMD). Digital subtraction angiography of the left internal carotid artery distribution demonstrates a large 1.5-cm-diameter aneurysm of the right anterior communicating artery. Aneurysms may be associated with systemic vasculopathies such as FMD.
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Fibromuscular dysplasia (FMD). Digital subtractio...

Fibromuscular dysplasia (FMD). Digital subtraction angiography of the left internal carotid artery distribution demonstrates a large 1.5-cm-diameter aneurysm of the right anterior communicating artery. Aneurysms may be associated with systemic vasculopathies such as FMD.

Small infarct in woman with fibromuscular dysplas...
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Media file 12: Small infarct in woman with fibromuscular dysplasia from dissected vertebral artery. An incidental aneurysm, or ovoid diverticula, is noted in the supraclinoid left internal carotid artery.
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Small infarct in woman with fibromuscular dysplas...

Small infarct in woman with fibromuscular dysplasia from dissected vertebral artery. An incidental aneurysm, or ovoid diverticula, is noted in the supraclinoid left internal carotid artery.

Small infarct in woman with fibromuscular dysplas...
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Media file 13: Small infarct in woman with fibromuscular dysplasia from dissected vertebral artery. An incidental aneurysm, or ovoid diverticula, is noted in the supraclinoid left internal carotid artery. Dissected vertebral artery.
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Small infarct in woman with fibromuscular dysplas...

Small infarct in woman with fibromuscular dysplasia from dissected vertebral artery. An incidental aneurysm, or ovoid diverticula, is noted in the supraclinoid left internal carotid artery. Dissected vertebral artery.

Small infarct in woman with fibromuscular dysplas...
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Media file 14: Small infarct in woman with fibromuscular dysplasia from dissected vertebral artery. An incidental aneurysm, or ovoid diverticula, is noted in the supraclinoid left internal carotid artery. Internal carotid angiogram.
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Small infarct in woman with fibromuscular dysplas...

Small infarct in woman with fibromuscular dysplasia from dissected vertebral artery. An incidental aneurysm, or ovoid diverticula, is noted in the supraclinoid left internal carotid artery. Internal carotid angiogram.

More on Fibromuscular Dysplasia

Overview: Fibromuscular Dysplasia
Differential Diagnoses & Workup: Fibromuscular Dysplasia
Treatment & Medication: Fibromuscular Dysplasia
Follow-up: Fibromuscular Dysplasia
Multimedia: Fibromuscular Dysplasia
References
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Further Reading

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Keywords

FMD, fibromuscular hyperplasia, medial hyperplasia, arterial fibrodysplasia, angiopathy, renal artery disease, stroke

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Contributor Information and Disclosures

Author

James A Wilson, MD, MSc, FRCPC, BSc(H), Neurologist and Clinical Neurophysiologist, Oconee Neurology Services
James A Wilson, MD, MSc, FRCPC, BSc(H) is a member of the following medical societies: American Academy of Neurology and Ontario Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Richard L Hughes, MD, Associate Professor, Department of Neurology, University of Colorado School of Medicine; Director, University of Colorado Affiliated Hospitals Stroke Project; Chief, Division of Neurology, Denver Health Medical Center
Richard L Hughes, MD is a member of the following medical societies: American Academy of Neurology, American Heart Association, American Medical Association, and North American Neuro-Ophthalmology Society
Disclosure: Nothing to disclose.

Medical Editor

Jeffrey L Saver, MD, Director, Stroke Center, Professor, Department of Neurology, University of California at Los Angeles Medical Center
Jeffrey L Saver, MD is a member of the following medical societies: American Academy of Neurology, American Heart Association, American Neurological Association, and National Stroke Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Howard S Kirshner, MD, Professor of Neurology, Psychiatry and Hearing and Speech Sciences, Vice Chairman, Department of Neurology, Vanderbilt University School of Medicine; Director, Vanderbilt Stroke Center; Program Director, Stroke Service, Vanderbilt Stallworth Rehabilitation Hospital; Consulting Staff, Department of Neurology, Nashville Veterans Affairs Medical Center
Howard S Kirshner, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Heart Association, American Medical Association, American Neurological Association, American Society of Neurorehabilitation, National Stroke Association, Phi Beta Kappa, and Tennessee Medical Association
Disclosure: Boehringer Ingelheim Honoraria Speaking and teaching; BMS/Sanofi Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching; Novartis Consulting fee Review panel membership

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Helmi L Lutsep, MD, Associate Professor, Department of Neurology, Oregon Health and Science University; Associate Director, Oregon Stroke Center
Helmi L Lutsep, MD is a member of the following medical societies: American Academy of Neurology and American Stroke Association
Disclosure: Co-Axia Consulting fee Review panel membership; Talecris Consulting fee Review panel membership; AGA Medical Consulting fee Review panel membership; Boehringer Ingelheim Honoraria Speaking and teaching; Boston Scientific Honoraria Speaking and teaching

 
 
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