Fibromuscolar dysplasia at the origin of the internal carotid artery: A rare site. Reports of two cases

Fibromuscolar dysplasia at the origin of the internal carotid artery: a rare site. Reports of two cases. Two cases of fibromuscolar dysplasya (FMD) at the origin of the internal carotid artery (ICA) are reported. The most common type of FMD presents the characteristic angiographic pattern of "string of beads" and affects a long tract upper the origin of the ICA. In our cases there was a focal FMD at the origin of the ICA, as a septum simulating an atheromatous plaque. Clinical and angiographic findings were similar to a tipical atheromatous stenosis. The only histological examination showed a focal FMD. Angiographic and histological findings are discussed. Our cases demonstrate that surgical correction can terminate repeated attacks of cerebral ischemia or prevent a catastrophic embolic event. Open or percutaneous angioplasty and anticoagulant therapy are a logical alternative when surgery is not possible.