Fibromuscular dysplasia
- Article
- 2021-03-09
Fibromuscular dysplasia (FMD) is the abnormal development or growth of cells in the walls of arteries that can cause blood vessels to narrow or swell. The carotid arteries, which pass through the neck and supply blood to the brain, are often affected. Arteries in the brain and kidneys can also be affected. A characteristic "bead chain" pattern, caused by the alternating narrowing and enlargement of the artery, can block or reduce blood flow to the brain, causing a stroke or minor stroke. Some patients do not experience symptoms of the disease, while others may have high blood pressure, dizziness or vertigo, chronic headache, intracranial aneurysm, ringing in the ears, facial weakness or numbness, neck pain, or vision changes. FMD is most often seen in people aged 25 to 50 and affects women more often than men. The disease can have more than one family member. The cause of FMD is unknown. An angiogram can detect the degree of narrowing or obstruction of the artery and identify changes such as a tear (dissection) or weak area (aneurysm) in the vessel wall. FMD can also be diagnosed using computed tomography, magnetic resonance imaging, or ultrasound.
Therapy
There is no standard protocol for treating FMD. Any treatment to improve blood flow is based on the arteries affected and the progression and severity of the disease. The carotid arteries should be tested if FMD is found elsewhere in the body, as carotid involvement is linked to an increased risk of stroke. Patients with minimal constriction can take a platelet aggregation inhibitor such as an aspirin or an anticoagulant daily to thin the blood and reduce the risk of a blood clot forming. Medicines such as aspirin can also be taken for headaches and neck pain, symptoms that can stem from FMD. Patients with arterial disease who smoke should be encouraged to quit, as smoking aggravates the disease. Further treatment may include angioplasty, in which a small balloon is inserted through a catheter and inflated to open the artery. Small tubes called stents can be inserted to keep arteries open. Surgery may be needed to treat aneurysms that can rupture and cause bleeding in the brain.
Prognosis
Currently, there is no cure for FMD. Medicines and angioplasty can reduce the risk of a first or recurring stroke. In rare cases, FMD-related aneurysms can burst and bleed in the brain, causing a stroke, permanent nerve damage, or death.
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