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Effective mechanical thrombectomy in a patient with hyperacute ischemic stroke associated with cardiac myxoma.

Abstract
Ischemic stroke is the most common neurologic manifestation of cardiac myxoma. However, there has been no current guideline on the treatment of hyperacute ischemic stroke due to cardiac myxoma. We describe a patient with hyperacute stroke caused by cardiac myxoma who had a good outcome with rapid recanalization through mechanical thrombectomy. A 46-year-old man was admitted with acute symptoms of right side hemiplegia and global aphasia. Brain computed tomography (CT) angiography showed a T occlusion of the left internal carotid artery. Intravenous recombinant tissue plasminogen activator was administered. However, his clinical symptoms did not improve. Thus, we performed endovascular treatment and had a successful outcome. A pathologic examination of the retrieved clot revealed a tumor emboli from a cardiac myxoma. Transthoracic echocardiogram revealed a left atrial myxoma in which a large mass was attached to the posterior wall of the aorta. The patient's neurologic deficits recovered with the exception of left eye blindness. Reperfusion therapy with mechanical thrombectomy might be safe and effective for the rapid revascularization of large vessel occlusions in hyperacute ischemic stroke, from which the tumor thrombi can be retrieved.
AuthorsSeol-Hee Baek, Soonchan Park, Nam Joon Lee, Youngjin Kang, Kyung-Hee Cho
JournalJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (J Stroke Cerebrovasc Dis) Vol. 23 Issue 9 Pg. e417-9 (Oct 2014) ISSN: 1532-8511 [Electronic] United States
PMID25174564 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Topics
  • Brain Ischemia (etiology, surgery)
  • Heart Neoplasms (complications, pathology)
  • Humans
  • Male
  • Middle Aged
  • Myxoma (complications, pathology)
  • Stroke (etiology, surgery)
  • Thrombectomy (methods)
  • Treatment Outcome
  • Vision Disorders (etiology)

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