Fibromuscular Dysplasia (FMD) Presenting as Intraventricular and Subarachnoid Hemorrhage
Journal Title: Clinical Radiology & Imaging Journal - Year 2017, Vol 1, Issue 3
Abstract
A 40 year old woman was found unresponsive in the seat of a forklift. Initial noncontrast CT imaging showed intraventricular and subarachnoid hemorrhage. Subsequently obtained CTA and MRA of the head showed a 4 mm right Posterior Inferior Cerebellar Artery (PICA) aneurysm and severe stenosis of the right internal carotid artery. Rupture of the right PICA aneurysm was thought to be the cause of the intraventricular and subarachnoid hemorrhage. The cause of the significant long segment narrowing of the right Internal Carotid Artery (ICA) remained of uncertain etiology because no neck angiographic imaging had been performed to this point. Conventional four vessel angiography was then performed, which showed a tapered cutoff of the proximal right ICA, just distal to the bulb, compatible with an occlusive dissection. Also, the conventional angiogram demonstrated a beaded appearance of the cervical segment of the left internal carotid artery. The right PICA aneurysm was also confirmed on the convention angiogram. Overall, the constellation of findings is consistent with fibromuscular dysplasia presenting as intraventricular and subarachnoid hemorrhage. In addition to the characteristic beaded appearance of a cervical segment of an internal carotid artery (left side in our case), our case also demonstrates the less common, although important, associated abnormalities seen with FMD, specifically, a cervical segment ICA dissection (right sided in our case) and intracranial aneurysm (ruptured right PICA aneurysm in our case).
Authors and Affiliations
Jacolby Short
Keywords
Related Articles
- EP ID EP565359
- DOI 10.23880/crij-16000113
- Views 70
- Downloads 0
Acute Hemorrhagic Encephalomyelitis Following Pneumococcal Meningitis in a 19 Years Old Girl
Acute hemorrhagic encephalomyelitis (AHEM) is a rare fulminant subtype of acute disseminated encephalomyelitis (ADEM). ADEM is characterized by multifocal neurological deficit, loss of consciousness and fever. These are...
Evaluation of 3DCT & MPR in Diagnosis of Craniofacial Fractures in Sudanese Population
1.1. Aims To determine sensitivity of three-dimensional computed tomography and multiplanar reconstruction in imaging cranifacial fractures in khartoum state 2017. 1.2. Methodology Descriptive, analytical study, were d...
Unrecognized Gastrostomy Tube Migration Eventually Causing Bowel Obstruction
A 45 year old female initially presented with traumatic evisceration of bowel requiring gastrostomy tube (G-tube) placement. An initial CT showed the G-tube to be in appropriate position. An additional inpatient CT scan...
Pulmonary Mucormycosis in a Child Diagnostic by CT and the Importance of the Reverse Halo Signal in Differential Diagnosis
Mucormycosis or zygomycosis is an uncommon opportunistic fungal infection caused by fungi of the order Mucorales in the class Zygomycetes. It’s far less common than other opportunistic fungal infections, such as Aspergil...
A Pseudoaneurysm of the Jugular Vein: A Case Report in a 74 Years Old Patient
The venous pseudoaneurysms of the neck are uncommon clinical entities that usually involve the internal jugular vein and less frequently the external jugular vein. Very few cases have been reported in the worlds academic...