This case highlights an atypical patient presenting with three spontaneous CeADs and Acute Ischemic Stroke, found to have Fibromuscular Dysplasia. Atypical features include older age than typical for Fibromuscular Dysplasia dissections, slowly progressing symptoms, and multiple dissections on presentation.  

The literature is sparse for differences in long-term outcomes between single versus multiple dissections, but this case suggests that patients with Fibromuscular Dysplasia who present with multiple dissections, present later in life, or have more slowly developing symptoms could be at increased risk for worse functional outcomes. More research is needed to better individualize treatment of Cervical Artery Dissections and improve outcomes.