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Co-existence of Three Types of Fibromuscular Dysplasia associated with True Posterior Communicating Artery Aneurysm

Ming Yang, Ming-Jun Cai, Guo-Zheng Xu, Lian-Ting Ma, Jun Li, Li Pan and Gang Chen

Coexistence of three types of fibromuscular dysplasia (FMD) is extremely rare and it has never been reported associated with true posterior communicating artery (PCoA) aneurysm. Here we present a 54-year-old patient with bilateral carotid and left vertebral arteries FMD involvement and a ruptured “true” aneurysm of the left PCoA itself that was treated with guglielmi detachable coils (GDCs) that allowed exclusion of the aneurysm with parent vessel preservation. As our case shows, flow-related true PCoA aneurysm and the common angioarchitectural aspects of PCoA of the previously reported cases highlight the importance of hemodynamic stress, reflected in changed blood flow patterns, for the formation and/or rupture of this unusual subgroup of intracranial aneurysms.