Cerebral Aneurysm associated with Fibromuscular Dysplasia of the Bilateral Vertebral Artery and Occipital Artery

Case Report

Abstract

Cerebral angiography of a 34-year-old male case of subarachnoid hemorrhage revealed a right posterior communicating artery aneurysm, associated with fibromuscular dysplasia (FMD) of the bilateral vertebral and occipital arteries. Because of a tendency of the level of consciousness to decrease, an intentionally delayed operation was performed on the 14th day after onset. The postoperative course was good and the patient was discharged with no neurological deficiency.
Twenty cases of cervico-cephalic FMD in the Japanese literature was reviewed, including 9 cases associated with cerebral aneurysm(s), and the features were compared with cases in the international literature. Higher incidence was observed in females and generally onset presented symptoms of ruptured aneurysm or cerebral ischemic attack with approximately equal frequency. FMD of the internal carotid artery had aneurysm(s) in the anterior half of Willis's ring, whereas FMD of the vertebral artery had aneurysm(s) in the posterior half of the ring. These findings suggest a possible relationship between the location of the cervico-cephalic FMD and that of intracranial aneurysm.