Journal of Yeungnam Medical Science

Case Report

Fibromuscular Dysplasia of the Distal Internal Carotid and Middle Cerebral Artery.: Ju Hyun Kim, Jun Lee; Yeungnam Univ J Med. 2009;26(1):78-83. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.78

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Fibromuscular dysplasia is an uncommon condition of idiopathic, non-inflammatory and non-atherosclerotic disease of the musculature of arterial walls. The disease is rare, but it commonly affects young and middle aged women. Isolated intracranial cerebral fibromuscular dysplasia is extremely rare because cerebral fibromuscular dysplasia usually affects extracranial vessels. A 26-year-old woman was admitted with right hemiplegia and global aphasia. Brain MRI and MRA demonstrated acute left middle cerebral artery territory infarction with a multifocal stenosis and dilatation of the left middle cerebra artery and left internal carotid. The characteristic conventional cerebral angiographic findings demonstrated a typical string-of-beads appearance in the left distal internal carotid artery and proximal portion of the left middle cerebral artery, which suggested a medial type fibromuscular dysplasia. We report a case of isolated intracranial fibromuscular dysplasia with left middle cerebral artery territory infarction. Fibromuscular dysplasia should be considered as a stroke risk factors in children and young adults, especially in patients with no known cardiovascular risk factors.

Citations

Citations to this article as recorded by

Cerebral Infarction and Recovery in a 12-Year-Old Child With Intracranial Fibromuscular Dysplasia
Min Hwan Kim, Jae In Lee, Shin-seung Yang
Brain & Neurorehabilitation.2023;[Epub] CrossRef

Original Article

The Predictors of Cerebral infarction in Mitral Stenosis.: Hyung Jun Kim, Woong Kim, Jong suk Lee, Gue Ru Hong, Jong Seon Park, Dong Gu Sin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 2000;17(1):75-81. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.75

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Abstract PDF: BACKGROUND
Systemic embolism especially, cerebral infarction is one of the most important complications in patients with mitral stenosis. The authors analyse the some that could predict the development of cerebral infarction in cases of mitral stenosis and propose preventive therapeutic measures. METHODS: Retrospective study of 127 patients with rheumatic mitral stenosis was performed by analysis their medical records for transthoracic(TTE) or transesophageal echocardiography(TEE) over a 12months period. The patients were divided into two groups according to the presence (Group I: n=26, age: 55+/-13 years) or absence (Group II: n=101, age: 48.5+/-13 years) of cerebral infarction. No significant difference was observed between the two groups with respect to sex and functional class. RESULTS: Patients of group I were older (55.0+/-13 vs 48.5+/-13;p<0.05), had more dilated left atrial size(5.10+/-0.48 vs 4.81+/-0.70;p<0.05) and smaller mitral surface area(1.01+/-0.39 vs 1.21+/-0.45;p<0.05). In Group I, the incidence of atrial fibrillation(22 out of 26 vs 57 out of 101;p<0.05) and spontaneous left intra-atrial contrast phenomenon(22 out of 26 vs 44 out of 101;p<0.05) was more frequently observed. On multivariate analysis, atrial fibrillation and anticoagulant therapy were the independent predictive factors. CONCLUSION: Age, left atrial dilatation, the severity of mitral stenosis, the presence of spontaneous contrast and especially the presence of atrial fibrillation are the main predictive factors of the development of cerebral infarction in mitral stenosis. Patients presenting one or several of these factors may benefit from prophylactic anticoagulant treatment.

Case Report

A case of primary antiphospholipid antibody syndrome showing vegetation on the mitral valve through echocardiography.: Seung Yeop Lee, Seung Kwon Park, Sung Hwan Yun, Yun Seok Jung, Hyen Jik Kim, Sung Hwan Lim, Jung Sang Hah, Wook Nyeun Kim; Yeungnam Univ J Med. 1998;15(2):350-358. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.350

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Abstract PDF: Antiphospholipid antibody syndrome(APS) is a well-known clinical syndrome characterized by recurrent arterial or venous thromboses, recurrent fetal loss, thrombocytopenia, together with high titers of sustained anticardiolipin antibody(aCL) or lupus anticoagulant(LA). Although systemic lupus erythematosus(SLE) and APS may coexist, a high proportion of patients manifesting the APS do not suffer from classical lupus or other connective tissue disease. The patient has been defined as having a primary antiphospholipid antibody syndrome. We experienced one case of primary APS with recurrent fetal loss, recurrent cerebral infarctions, positive anticardiolipin antibody IgG and fluttering vegetation on the mitral valve, without other connective tissue diseases including SLE. Forty-three old female had 2 out of 11 criteria for the diagnosis of SLE, such as thrombocytopenia and positive antinuclear antibody, but did not meet whole criteria. The patient was treated with ticlopidine, and anticoagulant therapy was recommended.

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