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Ale P, Gurung A, Hargroves D, Omojowolo O. Atrial myxoma: A cause for concern in multiple cerebral infarctions in absence of cardiac symptoms. BMJ Case Rep 2023; 16:e257157. [PMID: 38011961 PMCID: PMC10685979 DOI: 10.1136/bcr-2023-257157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Ischaemic cerebral infarct is the most common neurological manifestation of myxomas. We present a mid-70s man who was brought to the stroke unit with sudden onset right hemiparesis and dysarthria. Although he had risk factors for developing stroke like hypertension, hypercholesterolaemia, history of prostate cancer and new paroxysmal atrial flutter on admission, clinical suspicion and detailed investigations in the absence of cardiac symptoms revealed a 9 cm myxoma causing severe mitral stenosis. He underwent successful surgical resection with good functional recovery. This also highlights the need for thorough clinical examination especially in the absence of cardiac symptoms.
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Affiliation(s)
- Pramol Ale
- Stroke Medicine, Kent and Canterbury Hospital, Canterbury, UK
| | - Abinas Gurung
- Stroke Medicine, Kent and Canterbury Hospital, Canterbury, UK
| | - David Hargroves
- Stroke Medicine, Kent and Canterbury Hospital, Canterbury, UK
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Abstract
Every year, more than 795,000 people in the United States have a stroke, the vast majority of which are ischemic. Cardiac myxoma is an unusual cause of stroke and accounts for less than 1% of ischemic strokes. We present a case of a 56-year-old male with a history of hypertension, dyslipidemia, and type 2 diabetes mellitus, who presented with altered mental status, tinnitus, double vision, and diaphoresis. Due to concern for a cerebral vascular accident, a CT scan of the brain was obtained and showed no acute intracranial process. Brain MRI revealed multiple small acute infarcts involving bilateral posterior cerebral artery distribution. Further evaluation included transthoracic echocardiography that showed a large mobile mass in the left atrium measuring 3.5 x 2 cm intermittently projecting through the mitral valve. The patient underwent successful surgical resection of the left atrial mass. The pathology report confirmed the diagnosis of atrial myxoma. This case further highlights the importance of complete evaluation of stroke, including echocardiography, as well as the importance of careful surgical resection to prevent recurrence of systemic embolization and other complications of atrial myxoma.
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Affiliation(s)
| | - Emad Kandah
- Internal Medicine, McLaren Health Care, Michigan State University, Flint, USA
| | - Basel Abdelazeem
- Internal Medicine, McLaren Health Care, Michigan State University, Flint, USA
| | - Saed Alnaimat
- Cardiology, McLaren Health Care, Michigan State University, Flint, USA
| | - Arvind Kunadi
- Internal Medicine, McLaren Health Care, Michigan State University, Flint, USA
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Wan Y, Du H, Zhang L, Guo S, Xu L, Li Y, He H, Zhou L, Chen Y, Mao L, Jin H, Hu B. Multiple cerebral metastases and metastatic aneurysms in patients with left atrial Myxoma: a case report. BMC Neurol 2019; 19:249. [PMID: 31646971 PMCID: PMC6813067 DOI: 10.1186/s12883-019-1474-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 09/20/2019] [Indexed: 12/18/2022] Open
Abstract
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
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Affiliation(s)
- Yan Wan
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Hai Du
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Department of Neurology, Caidian People Hospital, Wuhan, 430100, China
| | - Lei Zhang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Shuang Guo
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Li Xu
- Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, China
| | - Yuanyuan Li
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Hui He
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Lian Zhou
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yunping Chen
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Ling Mao
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Huijuan Jin
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Bo Hu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
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