Bilateral Internal Carotid Artery Fibromuscular Dysplasia Resulting in Ischemic Stroke in an Elderly Woman

Abstract

Background— There is limited data regarding fibromuscular dysplasia in elderly patients particularly those with
ischemic stroke.
Case Description—An 84-year-old woman was admitted because she had sudden onset episodes of involuntary
movement her left hand compatible with alien hand syndrome. On physical examination, she was found to have
sensitive agnosia and diminished deep sensory perception of the left arm. Brain magnetic resonance imaging
demonstrated an area of restricted diffusion in right post Rolandic area. Computed tomographic angiography revealed
classical "string of beads" in the middle and distal cervical portion of both internal carotid arteries suggestive of
fibromuscular dysplasia.
Conclusion— We report a late presentation of fibromuscular dysplasia associated with ischemic stroke in an elderly
woman highlighting the need for recognition of the disease in elderly ischemic stroke patients.