Background: Cardiac myxoma is the most common benign cardiac tumor. Brain metastases or multiple cerebral aneurysms are extremely rare, especially for the case of both complications. Brain metastases are usually found at the same time or few months after the diagnosis or surgical removal of cardiac myxoma Case presentation: We describe a case of patient, operated for a cardiac myxoma, who presented multiple central nervous system metastases associated, cerebral aneurysms and subsequent intracerebral hemorrhage Conclusions: The long-term follow-up of the patients with atrial myxoma even after complete surgical excision is recommended, especially for the patient with central nervous system manifestations before atrial myxoma excision