A case of the left middle cerebral artery embolism due to fibromuscular dysplasia in the cervical internal carotid artery

IKEDA Norio, ABIKO Masaru, SAKAKURA Takanori, NAKANO Shigeki, NISHIZAKI Takafumi

doi:10.5797/jnet.6.40

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Other Title

頚部内頚動脈の線維筋性形成異常症に起因した左中大脳動脈塞栓症の1例
症例報告頚部内頚動脈の線維筋性形成異常症に起因した左中大脳動脈塞栓症の1例
ショウレイホウコクケイブナイケイドウミャクノセンイキンセイケイセイイジョウショウニキインシタヒダリチュウダイノウドウミャクソクセンショウノ 1レイ

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Abstract

Objective: We report a rare case of left middle cerebral artery embolism due to fibromuscular dysplasia (FMD) in the cervical internal carotid artery.<br>Case presentation: A 47-year-old female presented with motor aphasia and right hemiparesis. MRI showed early ischemic changes in the left frontal lobe and insular cortex. Cervical MRA showed irregularity of the vessel wall in the left cervical internal carotid artery and occlusion of the left middle cerebral artery (MCA). Because the patient was ineligible for intravenous recombinant tissue plasminogen activator, we chose endovascular therapy for recanalization. A left common carotid angiogram demonstrated typical findings of FMD and occlusion extending from the distal M1 to M2 segment of the MCA. Therefore, we performed balloon catheter disruption of the thrombus without thrombectomy using a Merci retriever. The occluded MCA was successfully recanalized and good clinical outcome was obtained.<br>Conclusion: We considered that the left MCA occlusion was caused by artery-to-artery embolism derived from FMD. This is the first report of balloon catheter disruption of the thrombus due to FMD.

Journal

Journal of Neuroendovascular Therapy

Journal of Neuroendovascular Therapy 6 (1), 40-45, 2012

The Japanese Society for Neuroendovascular Therapy

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