Carotid-bulb atypical fibromuscular dysplasia in young Afro-Caribbean patients with stroke.

Autor:	Joux J; From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies. julien.joux@gmail.com., Chausson N; From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies., Jeannin S; From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies., Saint-Vil M; From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies., Mejdoubi M; From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies., Hennequin JL; From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies., Deschamps L; From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies., Smadja D; From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies., Olindo S; From the Departments of Neurology (J.J., N.C., S.J., M.S.-V., D.S., S.O.), Radiology (M.M.), Vascular Surgery (J.-L.H.), and Pathology (L.D.), Fort-de-France University Hospital, Martinique, French West Indies.
Jazyk:	angličtina
Zdroj:	Stroke [Stroke] 2014 Dec; Vol. 45 (12), pp. 3711-3. Date of Electronic Publication: 2014 Oct 30.
DOI:	10.1161/STROKEAHA.114.007313
Abstrakt:	Background and Purpose: An atypical form of fibromuscular dysplasia located in the internal carotid-bulb (CaFMD) is thought to be uncommon and is poorly described as a cause of ischemic stroke in the young. This study aimed to obtain a better description of CaFMD in Afro-Caribbean population, who could be particularly affected by it. Methods: This study included consecutive patients <55 years consulting at Fort-de-France University Hospital Stroke Center (Martinique, FWI) found to have CaFMD as the only cause after a comprehensive work-up. CaFMD was diagnosed when computed tomographic angiography showed a bulbar spur without calcification. Results: Twenty-five patients with stroke and CaFMD were identified. Computed tomographic angiography showed 2 CaFMD patterns: a thin (n=15) or thick (n=10) spur. Three patients initial computed tomographic angiography images showed a mural thrombus overlying the CaFMD. CaFMD was surgically removed from 7 of 25 and 20 of 25 patients who received antiplatelet therapy; after mean follow-up of 25.3±19.5 months, their respective recurrence rates were 0% and 30%. Conclusions: CaFMD could be a common condition in young Afro-Caribbeans with carotid-territory ischemic stroke. Recurrences were frequent under antiplatelet treatment, while surgical CaFMD removal seemed more effective. (© 2014 American Heart Association, Inc.)
Databáze:	MEDLINE
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