Fibromuscular dysplasia may herald symptomatic recurrence of cervical artery dissection.
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.


CONCLUSIONS
The rate of symptomatic CAD recurrence was 1% per year and was often related to FMD.
de Bray
J M
JM
Department of Neurology, University Hospital Angers, Angers, France. jmdebray@chu-angers.fr
Marc
G
G
Pautot
V
V
Vielle
B
B
Pasco
A
A
Lhoste
P
P
Dubas
F
F
D000328:Adult; D015901:Angiography, Digital Subtraction; D000925:Anticoagulants / Q000627:therapeutic use; D020215:Carotid Artery, Internal, Dissection / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D020217:Vertebral Artery Dissection / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000473:pathology
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors