Abstract
We administered intravenous thrombolytic therapy to a 51-year-old female patient with
a 101-min stroke onset. The patient was unconscious during the manifestation of symptoms.
Computed tomography angiography examination of the intracranial artery at the time
of admission suggested that the left middle cerebral artery was occluded. The patient
regained consciousness after the intravenous thrombolytic treatment was administered.
On an urgent cerebral angiography, it was revealed that the recanalization of the
left middle cerebral artery was successful. Although blood perfusion was restored,
occlusion of the distal blood flow remained. The symptoms of the patient gradually
improved after the treatment. However, 6 months after the onset of the condition,
intracranial aneurysms formed distal to the recanalized arteries that were previously
embolized. The full process underlying the development of cerebral embolism caused
by atrial myxomas and subsequent formation of aneurysms is illustrated in this patient.
Although the underlying mechanism remains unclear, intravenous thrombolysis can successfully
restore cerebral blood flow in and may improve the prognosis of patients with cerebral
embolism caused by cardiac myxoma. Despite the positive revascularization therapy,
the occurrence of the complication of intracranial aneurysms is possible. Long-term
follow-up to evaluate the progression of myxomatous aneurysms after cerebral embolism
with conservative treatment may be a suitable strategy for managing such patients.
Key Words
Abbreviations:
CT (computed tomography), CTA (computed tomography angiography), DSA (digital subtraction angiography), MRA (magnetic resonance angiography), MRI (magnetic resonance imaging)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Cardiac myxoma the great imitators: comprehensive histopathological and molecular approach.Int J Cardiol. 2013; 164: 7-20
- Safe and effective intravenous thrombolysis for acute ischemic stroke caused by left atrial myxoma.J Stroke Cerebrovasc Dis. 2009; 18: 398-402
- Intracerebral hemorrhage after intravenous thrombolysis in patients with cerebral microbleeds and cardiac myxoma.Front Neurol. 2014; 5: 252
- Central nervous system manifestations of cardiac myxoma.Arch Neurol. 2007; 64: 1115-1120
- Multiple intracranial aneurysms followed left atrial myxoma: case report and literature review.J Thorac Dis. 2013; 5: E227-E231
- Intracranial aneurysm disappeared after resection of a cardiac myxoma.Int J Clin Exp Med. 2015; 8: 8214-8217
- Cerebral aneurysm in association with left atrial myxoma.Can J Neurol Sci. 2019; 46: 637-639
- Metastatic fusiform aneurysms from atrial myxoma: a case report and literature review.J Neuroradiol. 2017; 44: 400-403
- Multiple cerebral myxomatous aneurysms: what is the optimal treatment?.J Stroke Cerebrovasc Dis. 2015; 24: 232-238
- The dynamic natural history of cerebral aneurysms from cardiac myxomas: a review of the natural history of myxomatous aneurysms.Interv Neuroradiol. 2018; 24: 277-283
Article info
Publication history
Published online: March 24, 2020
Accepted:
February 26,
2020
Received in revised form:
January 28,
2020
Received:
November 5,
2019
Footnotes
Conflicts of Interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104796
Copyright
© 2020 Elsevier Inc. All rights reserved.