Rapid growth of intracranial aneurysms secondary to cardiac myxoma

Suzuki, Tatsunori; Nagai, R; Yamazaki, T.; Shiojima, Ichiro; Maemura, Kosuke; Yamaoki, Kazuhide; Tanaka, Nobuyuki; Machida, Toshio; Kotsuka, Yutaka; Furuse, Akira; Yazaki, Yoshinao

doi:10.1212/wnl.44.3_part_1.570

Cited by 19 publications

(6 citation statements)

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“…This theory of "tumoral aneurysms" is compatible with observations that have shown rapid growth or regression of these aneurysms 12,17,18 . According to Stock 19 , myxoma cells could pro- liferate in the vessel wall with or without apoptosis: without apoptosis the mass would grow progressively in the lumen leading to occlusion of the cerebral vessel and infarction.…”

Section: Discussionsupporting

confidence: 86%

Multiple Cerebral Aneurysms Caused by Cardiac Myxoma

Sédat

Chau

Dunac³

et al. 2007

Interv Neuroradiol

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Section: Discussionsupporting

confidence: 86%

Multiple Cerebral Aneurysms Caused by Cardiac Myxoma

Sédat

Chau

Dunac³

et al. 2007

Interv Neuroradiol

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“…Eventually, there were 47 reports of 49 cases and a total of 50 cases analyzed [3,. The median age was 38 years (95%CI, [34][35][36][37][38][39][40][41][42], and female/male ratio was 3.17:1. Resection of atrial myxoma was performed first in 90% (45) cases.…”

Section: Review and Analysis Of The Literaturementioning

confidence: 99%

Anesthesia management of atrial myxoma resection with multiple cerebral aneurysms: a case report and review of the literature

et al. 2020

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Background: Embolic stroke is a common complication of atrial myxoma, whereas multiple cerebral aneurysms associated with atrial myxoma is rare. The pathogenesis of the cerebral vascular disease related to an atrial myxoma is still not well known, and there are no guidelines to guide treatment and anesthesia management in such patients. Case presentation: In this report, we present a 38-year-old woman with occasional dizziness and headache diagnosed as multiple cerebral fusiform aneurysms, in whom transthoracic echocardiography revealed a mass attached to the interatrial septum in the left atrium. Myxoma resection was performed in fast track cardiac surgery pathway without neurological complications, and no intervention was carried out on the cerebral aneurysms. She was discharged home 6 days after the procedure for followed-up. Furthermore, we reviewed and analyzed the literature in the PubMed and Google Scholar databases in order to conclude the optimal treatment in such cases. Conclusions: Atrial myxoma-related cerebral aneurysms are always multiple and in a fusiform shape in most occasions. Early resection of myxoma and conservative therapy of aneurysm is an optimal treatment. TEE and PbtO 2 monitoring play an essential role in anesthesia management. Fast track cardiac anesthesia is safe and effective to early evaluate neurological function. Long term follow-up for "myxomatous aneurysms" is recommended. And outcome of most patients is excellent.

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“…Several mechanisms have been described for the formation of an arterial aneurysm. One of the most likely is that particulates from the tumor mass embolize into the vasa vasorum of cerebral arteries with subsequent weakening of the subintimal tissue of the vessel wall [Suzuki 1994;Furuya 1995;Sabolek 2005]. Other authors believe that perivascular damage to cerebral vessels may be due to their occlusion by tumor emboli and to endothelial scarring [Sabolek 2005]; however, this hypothesis contradicts the fact that most reported aneurysms occur in the absence of a history of cerebrovascular embolization [Herbst 2005].…”

Section: Pathogenesismentioning

confidence: 99%

“…Because of the slow growth of myxomatous tissue in situ and the slow destruction of the arterial wall tissue, there is a delay between embolism of the tumor material and the destruction of the vessel wall with aneurysm formation [Sabolek 2005]. This growth can proceed even after the intracardiac mass has been removed [Suzuki 1994].…”

Section: Pathogenesismentioning

confidence: 99%

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Surgical Resection of Left Atrial Myxoma Presenting with Acute Multiple Hemorrhagic Cerebral Infarctions: A Case Report

Katz¹,

Finkelshtein²,

Raichman³

et al. 2008

The Heart Surgery Forum

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Brain ischemia resulting from left atrial myxoma embolization has been well documented. In contrast, the link between the development of intracerebral hemorrhage and myxoma in these patients has little coverage in the literature. The main theory describing this relationship stems from the fact that cardiac myxoma cells metastasize to the brain's vessels, causing destruction of the arterial wall with subsequent formation of fusiform aneurysm and further intracranial bleeding. It is assumed that when a diagnosis of left atrial myxoma with neurologic manifestations is made, surgical resection should be performed without delay to prevent repeated tumor embolization; however, systemic anticoagulation treatment during cardiac surgery with cardiopulmonary bypass is not recommended immediately after intracerebral hemorrhage occurs because of the possibility of extending the infarct's size. We describe a patient with acute hemorrhagic brain infarction and an echocardiographically demonstrated left atrial myxoma that was surgically resected successfully in the acute phase after the onset of the neurologic symptoms.

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Rapid growth of intracranial aneurysms secondary to cardiac myxoma

Cited by 19 publications

References 0 publications

Multiple Cerebral Aneurysms Caused by Cardiac Myxoma

Multiple Cerebral Aneurysms Caused by Cardiac Myxoma

Anesthesia management of atrial myxoma resection with multiple cerebral aneurysms: a case report and review of the literature

Surgical Resection of Left Atrial Myxoma Presenting with Acute Multiple Hemorrhagic Cerebral Infarctions: A Case Report

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