{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T01:05:45Z","timestamp":1779843945214,"version":"3.53.1"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"21","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,5,25]]},"abstract":"\n BACKGROUND<\/jats:title>\n Ruptured intracranial internal carotid artery dissecting aneurysm (IICDA) occurring in association with fibromuscular dysplasia (FMD) is exceptionally rare, and the optimal treatment strategy remains undefined.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 43-year-old woman presented with sudden severe headache and was transferred to the authors\u2019 hospital 2 days later after developing impaired consciousness. Initial CT revealed a diffuse subarachnoid hemorrhage with right-sided predominance. Digital subtraction angiography demonstrated a \u201cstring-of-beads\u201d appearance in the bilateral cervical internal carotid arteries (ICAs), a fusiform vertebral artery aneurysm, and a dissecting aneurysm of the right intracranial ICA, findings consistent with FMD. A high-flow extracranial-intracranial bypass was performed using a radial artery (RA) graft connecting the external carotid artery (ECA) to the middle cerebral artery (MCA) (ECA-RA-MCA), followed by surgical trapping of the affected ICA. The postoperative course was uneventful, and graft patency was confirmed using imaging. At the 3-month follow-up, the patient had no neurological deficits (modified Rankin Scale score 0).<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Ruptured IICDA associated with FMD is exceptionally rare. This case suggests that high-flow bypass with trapping may be a safe and effective treatment option in carefully selected patients.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE26221<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case26221","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:52:37Z","timestamp":1779288757000},"source":"Crossref","is-referenced-by-count":0,"title":["High-flow bypass and trapping for ruptured intracranial internal carotid artery dissection in fibromuscular dysplasia: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Hidenori","family":"Ohbuchi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Adachi Medical Center, Tokyo Women\u2019s Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kae","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adachi Medical Center, Tokyo Women\u2019s Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suguru","family":"Yokosako","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adachi Medical Center, Tokyo Women\u2019s Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitomi","family":"Ujiie","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adachi Medical Center, Tokyo Women\u2019s Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizuki","family":"Aoki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adachi Medical Center, Tokyo Women\u2019s Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanenari","family":"Machida","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adachi Medical Center, Tokyo Women\u2019s Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayu","family":"Kambe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adachi Medical Center, Tokyo Women\u2019s Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Kubota","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Adachi Medical Center, Tokyo Women\u2019s Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Stroke","first-page":"53","article-title":"Fibromuscular dysplasia and the brain. 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Stroke. 1982;13(1):46-52. doi:10.1161\/01.str.13.1.46"},{"issue":"5","key":"bib3","series-title":"Stroke","first-page":"617","article-title":"Angiographic spectrum of cervical and intracranial fibromuscular dysplasia","volume":"8","author":"Osborn","year":"1977","unstructured":"Osborn AGAnderson RE.Angiographic spectrum of cervical and intracranial fibromuscular dysplasia. Stroke. 1977;8(5):617-626. doi:10.1161\/01.str.8.5.617"},{"issue":"3","key":"bib4","series-title":"Eur Stroke J","first-page":"XXXIX","article-title":"ESO guideline for the management of extracranial and intracranial artery dissection","volume":"6","author":"Debette","year":"2021","unstructured":"Debette SMazighi MBijlenga PESO guideline for the management of extracranial and intracranial artery dissection. 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