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Stroke secondary to FMD

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Alternative Names    Return to top

Fibromuscular dysplasia (FMD) - stroke secondary to

Definition    Return to top

Stroke secondary to fibromuscular dysplasia (FMD) is an interruption of blood flow to the brain due to problems with the structure of the arteries that supply the brain with blood.

Causes    Return to top

A stroke is an interruption of the blood supply to any part of the brain. Stroke secondary to fibromuscular dysplasia (FMD) primarily affects women, especially those older than 50.

FMD is an inherited disorder involving the ongoing destruction of arterial blood vessels. There are areas of increased muscle and fibrous (scar-like) tissue in the wall of the affected arteries, which alternate with enlarged (dilated) areas of destroyed tissue. This irregularity in the arteries increases the risk for stroke.

The disease may affect the neck arteries (carotids) that supply blood to the brain, or the arteries within the brain (cerebral) and cause stroke. It may also affect the following arteries:

Secondary symptoms include high blood pressure, leg pain, heart attack, kidney failure, and other disorders.

Risks include a personal or family history of FMD.

Symptoms    Return to top

Exams and Tests    Return to top

The exact location and extent of the stroke, and changes in the arteries indicating FMD may be seen on:

An arteriography or angiography of the head may show blood vessel changes such as narrowing of the arteries.

An artery biopsy confirms the diagnosis of FMD (this is not performed on brain blood vessels).

Treatment    Return to top

Stroke is a serious condition. The sooner treatment is received, the better the person will do, and the lower the chance of permanent disability or death. Treatment depends on the severity of the stroke and its affects.

Careful monitoring can reveal problems with the arteries before injury occurs. In some circumstances, surgery to repair any blockages can prevent complications.

Evaluation and treatment of hypertension (high blood pressure) associated with kidney disorders may be appropriate in some people with stroke secondary to FMD.

Outlook (Prognosis)    Return to top

The outcome from any stroke depends on the initial severity, and ability to treat it quickly. Although FMD is associated with an increased risk of stroke and other complications, many patients can do well with good treatment and close attention to any secondary complications. As with other types of stroke, strokes from FMD can result in death or severe disability. Complete or significant recovery from a stroke is also possible.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Stroke is a medical emergency. Immediately go to the emergency room or call the local emergency number (911 in the United States) if signs of a stroke occur.

Prevention    Return to top

Awareness of personal or family history of FMD can allow earlier diagnosis of the cause of stroke.

Aspirin therapy (81mg a day or 100mg every other day) is now recommended for stroke prevention in women under 65 as long as the benefits outweigh the risks. It should be considered for women over age 65 only if their blood pressure is controlled and the benefit is greater than the risk of gastrointestinal bleeding and brain hemorrhage.

References    Return to top

Mosca L, Banka CL, Benjamin EJ, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update. Circulation. 2007; Published online before print February 19, 2007.

Update Date: 2/20/2007

Updated by: Updated by A.D.A.M. Editorial Team: Greg Juhn, M.T.P.W., David R. Eltz, Kelli A. Stacy. Previously reviewed by Kenneth Gross, M.D., Private Practice, Neurology, North Miami, FL. Review provided by VeriMed Healthcare Network. (September 2006)

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