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2015 ; 30
(2
): 225-34
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Stroke of a cardiac myxoma origin
#MMPMID26107455
Yuan SM
; Humuruola G
Rev Bras Cir Cardiovasc
2015[Mar]; 30
(2
): 225-34
PMID26107455
show ga
OBJECTIVE: The clinical features of cardiac myxoma stroke have not been
sufficiently described. Debates remain concerning the options and timing of
treatment and the clinical outcomes are unknown. This article aims to highlight
the pertinent aspects of this rare condition. METHODS: Data source of the present
study came from a comprehensive literature collection of cardiac myxoma stroke in
PubMed, Google search engine and Highwire Press for the year range 2000-2014.
RESULTS: Young adults, female predominance, single cerebral vessel (mostly the
middle cerebral artery), multiple territory involvements and solitary left atrial
myxoma constituted the outstanding characteristics of this patient setting. The
most common affected cerebral vessel (the middle cerebral artery) and areas (the
basal ganglion, cerebellum and parietal and temporal regions) corresponded well
to the common manifestations of this patient setting, such as conscious
alteration, ataxia, hemiparesis and hemiplegia, aphasia and dysarthria. Initial
computed tomography scan carried a higher false negative rate for the diagnosis
of cerebral infarction than magnetic resonance imaging did. A delayed surgical
resection of cardiac myxoma was associated with an increased risk of potential
consequences in particular otherwise arterial embolism. The mortality rate of
this patient population was 15.3%. CONCLUSION: Cardiac myxoma stroke is rare.
Often does it affect young females. For an improved diagnostic accuracy, magnetic
resonance imaging of the brain and echocardiography are imperative for young
stroke patients in identifying the cerebral infarct and determining the stroke of
a cardiac origin. Immediate thrombolytic therapy may completely resolve the
cerebral stroke and improve the neurologic function of the patients. An early
surgical resection of cardiac myxoma is recommended in patients with not large
territory cerebral infarct.
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