Stroke and fibromuscular dysplasia: Confirmation by renal magnetic resonance angiography

• Published in: Pediatric neurology 1998-02, Vol.18 (2), p.172-175
• Main Authors: Leventer, Richard J., Kornberg, Andrew J., Coleman, Lee T., Phelan, Ethna M., Kean, Michael J.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cerebrovascular Disorders - diagnosis; Child; Fibromuscular Dysplasia - diagnosis; Humans; Magnetic Resonance Angiography; Male; Medical sciences; Neurology; Renal Artery; Tropical medicine; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/S0887-8994(97)00159-8

Childhood stroke is uncommon and may require extensive evaluation to elucidate an underlying cause. A 9-year-old boy had clinical and magnetic resonance imaging (MRI) features of an ischemic event in the left middle cerebral artery territory. Magnetic resonance angiography (MRA) revealed beading of the left middle cerebral artery, consistent with irregular blood flow secondary to turbulence or luminal narrowing. Conventional angiography of the cerebral vessels confirmed the findings of cerebral MRA and raised further the suspicion of fibromuscular dysplasia (FMD). MRA of the renal vessels was subsequently performed, revealing beading of the left renal artery and confirming the diagnosis of FMD. MRA, a rapid and less invasive technique associated with far less morbidity and mortality as compared with conventional angiography, may prove to be as sensitive as conventional angiography in detecting the changes of FMD. MRA of the renal arteries should be performed with initial cranial MRI and MRA in children who present with cerebral infarction of possible vascular origin. This may obviate the need to perform further investigations and may make early diagnosis possible at the first MRI scan and under a single general anesthetic.