title: Carotid and vertebral arterial fibromuscular dysplasia masquerading as severe preeclampsia: a case report.
abstract: BACKGROUND
  Fibromuscular dysplasia is a non-atherosclerotic noninflammatory vascular disease that can affect any vascular bed. Dysplasia of the intima, media, or adventitia layer of the affected arteries causes stenosis and hypertension. Pregnant or post-partum patients may present with hypertension and be mistakenly diagnosed with preeclampsia.
  
  
  METHODS
  A 26 year old Gravida 1 Para 1 female 20 days post partum from a spontaneous vaginal delivery was transported from an outlying facility due to severely elevated blood pressure and transient left arm numbness and left sided facial droop. Upon arrival the patient was begun on intravenous magnesium sulfate and labetalol for a presumptive diagnosis of severe post partum preeclampsia. Her blood pressure and symptoms responded promptly. Due to her neurologic symptoms a magnetic resonance angiogram was ordered revealing 90% stenosis of her bilateral carotid and vertebral arteries.
  
  
  CONCLUSIONS
  Severe hypertension and minimal neurologic symptoms may be the presenting symptoms for fibromuscular dysplasia. Cranial imaging is warranted in any pregnant or post partum patient who presents with these symptoms to allow appropriate treatment.
authors: Department of Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, USA.
authors: Brenda
authors: B
authors: Dawley
authors: Adam
authors: A
authors: Ritchie
mesh_terms: D000328:Adult; D002339:Carotid Arteries / Q000473:pathology; D003951:Diagnostic Errors; D005260:Female; D005352:Fibromuscular Dysplasia / Q000175:diagnosis*; D006801:Humans; D018810:Magnetic Resonance Angiography; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D011644:Puerperal Disorders / Q000175:diagnosis*; D014711:Vertebral Artery / Q000473:pathology