Objective 
ACA infarcts comprise approximately two percent of ischemic strokes and are usually due to artery-artery embolism from ICA disease. We present a rare case of ACA-territory stroke due to ACA dissection from fibromuscular dysplasia (FMD) in a young woman. 

Case Summary
A 43 year left handed woman developed acute right hemiparesis, predominantly affecting the lower limb. She had well controlled stage 2 hypertension for few years. On examination, 15 days later, she was ambulant with minimal support (NIHSS 4, mRS 1). MRI brain showed left ACA-territory infarct with occlusion of the left ACA. Cerebral DSA revealed characteristic features of FMD. There was dissection of the proximal left ACA with distal occlusion, 5 mm saccular wide-necked intradural, para-ophthalmic, right ICA aneurysm, bilateral vertebral artery dolichoectasia, 360-degree vascular loop of the left vertebral artery, and string-of-beads appearance of bilateral renal arteries. The ACA dissection was treated conservatively. However to prevent SAH, endovascular flow diversion (Fred®Microvention,CA,USA) for right ICA aneurysm was performed (followed by dual antiplatelets). The hemiparesis resolved within 3 months. Repeat DSA showed healing of the left ACA dissection with recanalisation of the artery, and exclusion of the right ICA aneurysm from the circulation. 

Conclusions
We report a uncommon case of young stroke due to ACA dissection from FMD that showed clinical and angiographic recovery with conservative treatment. Additionally, our case highlights the spectrum of FMD manifestations (such as aneurysms), that may require varied treatment approaches

YOUNG-STROKE DUE TO ACA DISSECTION SECONDARY TO FIBROMUSCULAR DYSPLASIA