title: Carotid diaphragm: Atypical fibromuscular dysplasia or atheromatous lesions?
abstract: Atypical fibromuscular dysplasia (FMD) is an underdiagnosed cause of ischemic stroke. The typical angiographic pattern of a septum on the posterolateral side of a carotid megabulb is highly suggestive of atypical FMD. We report here on two patients with this highly suggestive pattern of carotid atypical FMD, but which histological examination revealed to be atheromatous lesions. Interestingly, contrast-enhanced ultrasound of the carotid artery showed enhancement of the spur, which should never be the case with an FMD lesion, which has no vasa vasorum. Our findings suggest that the results of studies reporting stenting of atypical FMD in cervical arteries should be interpreted with caution.
authors.affiliation: Department of neurology and stroke center, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France. Electronic address: chaari.dhouha@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Chaari
authors.affiliation: Department of angiology, centre hospitalier de Versailles, 78150 Le Chesnay, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Baud
authors.affiliation: Department of pathology, AP-HP Bichat university hospital, Paris-Diderot university and medical school, 75018 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Deschamps
authors.affiliation: Department of vascular surgery, clinic Labrouste, 75015 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Petitjean
authors.affiliation: Department of angiology, centre hospitalier de Versailles, 78150 Le Chesnay, France.
authors.forename: A
authors.initials: A
authors.lastname: Maurizot
authors.affiliation: Department of neurology and stroke center, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France.
authors.forename: M-L
authors.initials: ML
authors.lastname: Chadenat
authors.affiliation: Department of radiology, centre hospitalier de Versailles, 78150 Le Chesnay, France.
authors.forename: M
authors.initials: M
authors.lastname: de Malherbe
authors.affiliation: Department of neurology and stroke center, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France.
authors.forename: A
authors.initials: A
authors.lastname: Jaoua
authors.affiliation: Department of neurology and stroke center, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France; Versailles Saint-Quentin-en-Yvelines university, 78000 Versailles, France.
authors.forename: F
authors.initials: F
authors.lastname: Pico
mesh_terms: D000328:Adult; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005352:Fibromuscular Dysplasia / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000473:pathology; D020521:Stroke / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography
keywords: Atheroma; Fibromuscular dysplasia; Septae; Spur; Stroke