Abstract
The patient was a 43-year-old woman. She was brought to the hospital by ambulance with left hemiparesis, and cerebral infarction in the right cerebral hemisphere was observed on head MRI. Tubular stenosis in both internal carotid arteries near the first vertebral body was observed by cerebral angiography, and cerebral infarction caused by fibromuscular dysplasia (FMD) of the internal carotid arteries was diagnosed. Neurological symptoms gradually worsened despite anticoagulative treatment, and since MRI revealed enlargement of the cerebral infarction on the right cerebral hemisphere and a new cerebral infarction on the left cerebral hemisphere, percutaneous transluminal angioplasty (PTA) was performed on both internal carotid arteries. Worsening of neurological symptoms was not observed postoperatively, and although slight paralysis remained on the left side, she was discharged ambulatorily and was socially rehabilitated. Endovascular treatment that can be performed simultaneously on both sides was considered useful in a case such as this with internal carotid artery FMD causing progressive exacerbation. Angioplasty using only a balloon (POBA: plain old balloon angiography) is considered the first choice for FMD, but rupture or dissection of the intima occurs easily in POBA, and in such cases stenting is useful for rescue procedure.
