Intracranial FMD with a typical string-of-beads aspect (basilar artery, carotid, middle cerebral artery) is usually an intracranial extension of extracranial lesions [29].
In 2012, Savard et al. [22] proposed a simplified classification based only on two angiographic cervico-encephalic subtypes of FMD: the multifocal (presence of ≥2 stenoses on a given vessel segment with or without the typical string-of-beads appearance) and unifocal (presence of a single focal or tubular stenosis) types.
a Renal CTA with coronal plane MIP reconstruction, showing the typical "string-of-beads" aspect of the right renal artery, in favour of medial FMD.
c Right vertebral angiogram showing the typical string-of-beads aspect.
With typical string-of-beads lesions involving the renal and/or carotid arteries, possible differential diagnoses are limited.
b and c Three-dimensional gadolinium-enhanced MRA reconstructions in the same patient showing the typical string-of-beads aspect (white arrows) of the internal carotid artery, highly suggestive of FMD.
d Right common carotid angiogram showing the typical string-of-beads aspect, in favour of FMD. e Cerebral 3D volume-rendered CTA of the dissecting aneurysm of the right antero-inferior cerebellar artery (white arrows) Open image in new window Fig. 10 Radiologic findings in a 65-year-old male patient with SAH of the posterior fossa.
A black musician with a typical string Cuban instrument called a "cuatro" completes the scene.
These patients may have suffered from TCA, a diagnosis that could only have been made after follow-up vascular imaging, revealing disappearance of the typical string of beads sign and stabilization or improvement of arteriopathy.
Though the slow movement of Schubert's final piano sonata does haunt two of the songs rather persistently, many of the other quotations are much less intrusive, and combined with the restraint of Nyman's instrumental writing, for a typical band of strings, saxophones, brass and piano, the whole work has a quiet seriousness that is very effective.
