“Metastatic” embolic lesions and enlarging pseudoaneurysms associated with cardiac myxoma

Chacón-Quesada, Tatiana; Maud, Alberto; O’Neill, Thomas; Ramos-Duran, Luis; Akle, Nassim; Cruz‐Flores, Salvador; Rodríguez, Gustavo J.

doi:10.1212/cpj.0000000000000105

Cited by 2 publications

(1 citation statement)

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“…Although no pathology specimen was obtained, his neurological deficits resolved following thrombolytic therapy. To the best of our knowledge, the role of thrombolytic therapy in acute stroke from myxoma embolism is unclear; the predisposition of embolised cells to invade cerebral vasculature forming ‘pseudo-aneurysms’ carries an increased risk for cerebral haemorrhage 4. Moreover, a myxoma may embolise associated with thrombus or as just tumour tissue itself, less amenable to thrombolytic therapy.…”

Section: Discussionmentioning

confidence: 99%

Atrial myxoma presenting as acute ischaemic stroke and chronic right lower leg claudication

2018

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A 48-year-old man presented with acute onset of left facial numbness, ataxic gait and double vision. He also complained of chronic right lower leg pain with acute onset a year prior to presentation. His vital signs were within normal limits. Physical exam was notable for right-sided intranuclear opthalmoplegia, decreased sensation to light touch on the left side of his body, left-sided dysmetria and ataxic gait. Neuroimaging showed evidence of acute stroke in the cerebellum and brainstem, for which he was treated with thrombolytics. An echocardiogram revealed a 5×3 cm left atrial myxoma, which was surgically resected. Subsequent imaging of his lower extremity revealed a chronic common iliac artery occlusion for which he underwent angioplasty. His claudication symptoms resolved, and he was without any neurological deficits at a 2-year follow-up visit.

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Section: Discussionmentioning

confidence: 99%