title: Carotid-bulb atypical fibromuscular dysplasia in young Afro-Caribbean patients with stroke.
abstract: OBJECTIVE
  An atypical form of fibromuscular dysplasia located in the internal carotid-bulb (CaFMD) is thought to be uncommon and is poorly described as a cause of ischemic stroke in the young. This study aimed to obtain a better description of CaFMD in Afro-Caribbean population, who could be particularly affected by it.
  
  
  METHODS
  This study included consecutive patients <55 years consulting at Fort-de-France University Hospital Stroke Center (Martinique, FWI) found to have CaFMD as the only cause after a comprehensive work-up. CaFMD was diagnosed when computed tomographic angiography showed a bulbar spur without calcification.
  
  
  RESULTS
  Twenty-five patients with stroke and CaFMD were identified. Computed tomographic angiography showed 2 CaFMD patterns: a thin (n=15) or thick (n=10) spur. Three patients initial computed tomographic angiography images showed a mural thrombus overlying the CaFMD. CaFMD was surgically removed from 7 of 25 and 20 of 25 patients who received antiplatelet therapy; after mean follow-up of 25.3±19.5 months, their respective recurrence rates were 0% and 30%.
  
  
  CONCLUSIONS
  CaFMD could be a common condition in young Afro-Caribbeans with carotid-territory ischemic stroke. Recurrences were frequent under antiplatelet treatment, while surgical CaFMD removal seemed more effective.
authors.affiliation: From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies. julien.joux@gmail.com.
authors.forename: Julien
authors.initials: J
authors.lastname: Joux
authors.affiliation: From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Chausson
authors.affiliation: From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies.
authors.forename: Séverine
authors.initials: S
authors.lastname: Jeannin
authors.affiliation: From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies.
authors.forename: Martine
authors.initials: M
authors.lastname: Saint-Vil
authors.affiliation: From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mejdoubi
authors.affiliation: From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Hennequin
authors.affiliation: From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies.
authors.forename: Lydia
authors.initials: L
authors.lastname: Deschamps
authors.affiliation: From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies.
authors.forename: Didier
authors.initials: D
authors.lastname: Smadja
authors.affiliation: From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Olindo
mesh_terms: D000328:Adult; D044383:Black People; D017691:Caribbean Region; D002346:Carotid Sinus / Q000473:pathology*; D002533:Cerebral Angiography; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000209:etiology*
keywords: blacks; fibromuscular dysplasia; stroke; young adult