Abstract
Objective: To report an original case of exertional headache (EH), fibromuscular dysplasia (FDM), carotid hypoplasia and subclavian theft syndrome in a young adult. Case Detail: In 2010, a 26-year-old male white patient began to suffer a severe, bilateral, frontoparietal, throbbing headache. During the attacks, he prefered to lie down, had photo and phonophobia and sometimes nausea. The attacks lasted 4 to 24 hours and happened only a few hours after the end of physical exercises, but never during them. In 2017, the patient had a normal physical examination, except for a decreased radial pulse on the right and an abolished carotid pulse on the right. The carotid and vertebral dupplex showed alterations suggesting partial theft of the right subclavian artery. Bilateral carotid and vertebral arteriography revealed irregular 80% stenosis in the proximal third of the brachiocephalic trunk, suggestive of FDM, and 60% stenosis extending to the common carotid arteries, right internal and external carotid arteries, with inversion of the flow in the right vertebral artery and thyreocervical trunk. Moreover, probable hypoplasia of common carotid arteries, right internal and external carotid artery was revealed. Final considerations: An original case was reported, which deserves attention, because it cannot be certain whether the EC is related to the vascular changes.