Stroke in a young man with fibromuscular dysplasia of the cranial vessels with anticardiolipin antibodies: a case report

A case of fibromuscular dysplasia (FMD), presenting with a non-hemorrhagic infarct is reported. Positivity of anticardiolipin antibodies suggested an immune response. A 40-year-old man presented with sudden onset of stroke, p receded by similar ischemic attacks. Computed tomography (CT) of the brain showed a recent non-hemorrhagic infarct in the left middle cerebral artery (MCA) territory and an old right MCA territory infarct. Serum was positive for anticardiolipin antibodies. These above findings were confirmed at auto psy. A portion of the internal carotid artery and the middle cerebral arter ies on both sides revealed features of FMD, with thrombosis. This case sugg ests an immune mechanism for FMD, hitherto unobserved in the cerebral circu lation.