Brain Embolism Secondary to Cardiac Myxoma in Fifteen Chinese Patients

Long, Youming; Gao, Cong

doi:10.1155/2014/718246

Cited by 10 publications

(10 citation statements)

References 29 publications

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“…Similar to a number of prior studies, the most common neurological manifestation of cardiac myxoma in our series was cerebral infarction [2,3,5,11] . Cardiac myxomas have been reported to cause 0.5% of cerebral infarctions and up to 30% of myxoma patients present with systemic or cerebral emboli [12] .…”

Section: Ischemic Strokes In Myxoma Patientssupporting

confidence: 90%

“…Cerebral embolism of cardiac myxoma has been reported as a rare cause of cerebral infarction and intracranial hemorrhage [2,3] . Tumor emboli have also been reported to cause intraparenchymal metastases and intracranial oncotic aneurysm formation.…”

Section: Neuroimaging Findings In Cardiacmentioning

confidence: 99%

“…Cardiac myxomas have been reported to cause 0.5% of cerebral infarctions and up to 30% of myxoma patients present with systemic or cerebral emboli [12] . Cerebral infarction in myxoma patients is thought to be secondary to embolization of tumor particles or thrombotic material covered with tumor cells [2] . This is supported by findings from case reports on mechanical thrombectomy for treatment of acute ischemic stroke in myxoma patients; demonstrating the presence of the myxomatous tissue in the retrieved emboli [13,14] .…”

Section: Ischemic Strokes In Myxoma Patientsmentioning

confidence: 99%

“…On imaging, infarction due a cardiac myxoma commonly manifests as multiple infarcts due to its embolic nature [2] . Prior studies have demonstrated that between 30 and 50% of patients have infarcts in multiple vascular territories, similar to our findings.…”

Section: Ischemic Strokes In Myxoma Patientsmentioning

confidence: 99%

See 3 more Smart Citations

Neuroimaging Findings in Cardiac Myxoma Patients: A Single-Center Case Series of 47 Patients

Brinjikji

Morris²,

Brown³

et al. 2015

Cerebrovasc Dis

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Background and Purpose: Cardiac myxomas can present with a myriad of neurological complications including stroke, cerebral aneurysm formation and metastatic disease. Our study had two objectives: (1) to describe the neuroimaging findings of patients with cardiac myxomas and (2) to examine the relationship between a history of embolic complications secondary to myxoma and intracranial aneurysm formation, hemorrhage and metastatic disease. We hypothesized that patients who present with embolic complications related to myxoma would be more likely to have such complications. Materials and Methods: We searched our institutional database for all patients with pathologically proven cardiac myxomas from 1995 to 2014 who received neuroimaging. Neuroimaging findings were categorized as acute ischemic stroke, intracerebral hemorrhage, oncotic aneurysm, and cerebral metastasis. Cardiac myxoma patients were divided into those presenting with embolic complications (i.e. lower extremity emboli or cerebral emboli) and those presenting with non-embolic complications prior to surgical resection of the myxoma. The prevalence of intracranial hemorrhage, myxomatous aneurysm formation, and cerebral metastases was compared in myxoma patients presenting with and without embolic complications using a Chi-squared test. Results: Forty-seven consecutive patients were included in this study. Sixteen patients (34.0%) had imaging evidence of acute ischemic stroke. Of these, 13 had acute ischemic strokes directly attributed to the cardiac myxoma (27.7%) and 3 had acute ischemic strokes secondary to causes other than myxoma (6.4%). Seven patients (14.9%) had aneurysms. Two patients (4.3%) had parenchymal metastatic disease on long-term imaging. Fourteen patients (29.8%) presented with ischemic symptoms that were attributed to cardiac myxoma (1 with lower extremity ischemia, 1 with lower extremity ischemia and ischemic stroke, and 12 with ischemic stroke). Patients presenting with embolic complications related to the myxoma (ischemic stroke or lower extremity ischemia) were more likely to have imaging evidence of intracranial hemorrhage (21.4 vs. 3.0%, p = 0.09), oncotic aneurysm (35.7 vs. 6.1%, p = 0.03), and cerebral metastasis (14.3 vs. 0.0%, p = 0.07) on follow-up imaging. Conclusions: Ischemic stroke and intracranial oncotic aneurysm were found in a substantial proportion of cardiac myxoma patients undergoing neuroimaging. Patients presenting with embolic complications of cardiac myxoma are more likely to have intracranial hemorrhage, intracranial oncotic aneurysms, and cerebral metastatic disease.

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Section: Ischemic Strokes In Myxoma Patientssupporting

confidence: 90%

Section: Neuroimaging Findings In Cardiacmentioning

confidence: 99%

Section: Ischemic Strokes In Myxoma Patientsmentioning

confidence: 99%

Section: Ischemic Strokes In Myxoma Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Neuroimaging Findings in Cardiac Myxoma Patients: A Single-Center Case Series of 47 Patients

Brinjikji

Morris²,

Brown³

et al. 2015

Cerebrovasc Dis

View full text Add to dashboard Cite

show abstract

“…To make things worse, left atrial myxoma could be responsible for induction of pulmonary embolism without any leakage through the cardiac septum by hypercoagulability, hemolysis, or heme oxygenase-1 up-regulation [21]. Indeed, the stroke, pulmonary embolism, syncope and multi-organ emboli are frequent clinical manifestations of cardiac myxomas that are true generators cardiogenic emboli [22,23,24,25,26]. It should be highlighted here that, embolus material can be both composed from both thrombus and tumor fragments and late complications of embolisation could be brain aneurysms and secondary myxomas [23].…”

Section: Introductionmentioning

confidence: 99%