Fibromuscular Dysplasia and Cerebrovascular Dissection: Insights From a Multicenter Cohort

Background Fibromuscular dysplasia (FMD) is a noninflammatory arteriopathy that may result in arterial stenosis, dissection, aneurysm, and tortuosity. Data remain limited on clinical features and outcomes of patients with FMD presenting with spontaneous cervical artery dissection (SCeAD). This study aimed to describe the characteristics and long‐term outcomes of this population. Methods We conducted a retrospective multicenter cohort study of patients diagnosed with both SCeAD and FMD at 3 US comprehensive stroke centers (2018–2023). Patients were identified through hospital records and vascular registries. Diagnosis of FMD and SCeAD was confirmed through imaging review by vascular neurologists or cardiologists. Outcomes included recurrent dissections, cardiovascular events (ischemic stroke, transient ischemic attack, myocardial infarction, subarachnoid hemorrhage) and mortality. Results Among 1632 patients with SCeAD, 97 (6%) had FMD diagnosis. The cohort was predominantly female (91%) and median age at FMD diagnosis was 50 years (interquartile range, 42–63). Carotid dissections were more frequent than vertebral dissections (86% versus 27%, P