Cerebral ischemic events in patients with carotid artery fibromuscular dysplasia.

From 1962 through 1979, 13,955 cerebral angiograms were made at our institution. Fibromuscular dysplasia (FMD) was identified in 82 (0.6%) patients. Follow-up information with specific reference to subsequent cerebral ischemic events (CIEs) was obtained in 79 (96%) patients and forms the basis for this study. The patients ranged in age from 18 to 76 years (mean, 58 years). Seventy-four of the patients were women. During an average follow-up of 60 months, three patients suffered subsequent CIEs (50, 136, and 216 months after the initial diagnosis). Fibromuscular dysplasia of the carotid artery is often an incidental angiographic finding, which may be manifested with focal CIEs. Most patients had no subsequent cerebrovascular symptoms related to the FMD. Therefore, we suggest that medical or surgical therapy be reserved for selected patients who have evidence of progressive cerebral ischemia.