STROKE AND FIBROMUSCULAR DYSPLASIA - CONFIRMATION BY RENAL MAGNETIC-RESONANCE ANGIOGRAPHY

Childhood stroke is uncommon and may require extensive evaluation to e lucidate an underlying cause. A 9-year-old boy had clinical and magnet ic resonance imaging (MRI) features of an ischemic event in the left m iddle cerebral artery territory. Magnetic resonance angiography (MRA) revealed beading of the left middle cerebral artery, consistent with i rregular blood flow secondary to turbulence or luminal narrowing. Conv entional angiography of the cerebral vessels confirmed the findings of cerebral MRA and raised further the suspicion of fibromuscular dyspla sia (FMD). MRA of the renal vessels was subsequently performed, reveal ing beading of the left renal artery and confirming the diagnosis of F MD. MRA, a rapid and less invasive technique associated with far less morbidity and mortality as compared with conventional angiography, may prove to be as sensitive as conventional angiography in detecting the changes of FMD. MRA of the renal arteries should be performed with in itial cranial MRI and MRA in children who present with cerebral infarc tion of possible vascular origin. This may obviate the need to perform further investigations and may make early diagnosis possible at the f irst MRI scan and under a single general anesthetic. (C) 1998 by Elsev ier Science Inc. All rights reserved.