Fibromuscular dysplasia angiogram

This 47-year-old female presented with headaches. Digital subtraction angiography images in the AP and lateral projection demonstrating the classic “string-of-beads” stenoses of the internal carotid artery (arrow heads), which is characteristic of medial fibromuscular dysplasia. The location of this disease often occurs at the C1 to C2 levels of the internal carotid artery. On rare occasion, such findings may extend continuously into the intracranial circulation (Spengos et al 2008). An aneurysm at the bifurcation of the right middle cerebral artery was also found in this patient (shown by the white arrow). (Contributed by Dr. Diana Gomez-Hassan.)