Abstract
Atrial myxomas arise from the multipotential mesenchymal cells of the endocardium and are usually left-sided. Most originate in the limbus fossae ovalis but 10 % are found in other regions including the anterior and posterior walls of the atria or the atrial appendages. The tumour is characterised by a gelatinous mass which is round, oval or polypoid in shape, often pedunculated. Ischaemic stroke due to embolic occlusion of the middle cerebral artery is the most common presentation of atrial myxoma although it is a very rare cause of stroke overall (<1 %). Other reported neurological manifestations include seizures (due to ischaemia, haemorrhage from myxoma-related anuerysms and cerebral metastases). The presentations and hyperacute and acute management are discussed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Lee VH, Connolly HM, Brown Jr RD. Central nervous system manifestations of cardiac myxoma. Arch Neurol. 2007;64(8):1115–20.
Wold LE, Lie JT. Cardiac myxomas: a clinicopathologic profile. Am J Pathol. 1980;101:219–40.
Novendstern SL, Silliman SL, Booth P. Cerebrovascular complications of atrial myxoma. Hosp Phys. 2001;3:39–42.
Acampa M, Tassi R, Guideri F, et al. Safety of intravenous thrombolysis in ischemic stroke caused by left atrial myxoma. Curr Drug Saf. 2011;6(5):343–5.
Ibrahim M, Iliescu C, Safi HJ, et al. Biatrial myxoma and cerebral ischemia successfully treated with intravenous thrombolytic therapy and surgical resection. Tex Heart Inst J. 2008;35:193–5.
Kohno N, Kawakami Y, Hamada C, et al. Cerebral embolism associated with left atrial myxoma that was treated with thrombolytic therapy. Case Rep Neurol. 2012;4:38–42.
Nagy CD, Levy M, Mulhearn TJ, et al. Safe and effective intravenous thrombolysis for acute ischemic stroke caused by left atrial myxoma. J Stroke Cerebrovasc Dis. 2009;18:398–402.
Sun MC, Tai HC, Lee CH. Intravenous thrombolysis for embolic stroke due to cardiac myxoma. Case Rep Neurol. 2011;3:21–6.
Chong JY, Vraniak P, Etienne M, et al. Intravenous thrombolytic treatment of acute ischemic stroke associated with left atrial myxoma: a case report. J Stroke Cerebrovasc Dis. 2005;14:39–41.
Ong CT. Intravenous thrombolysis associated with a high risk of hemorrhagic transformation in ischemic stroke patients with cardiac myxoma and over 70 years of age. Neurol Asia. 2012;17(3):193–7.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer-Verlag London
About this chapter
Cite this chapter
Oliver, R., Perry, R. (2015). Bihemispheric Infarcts. In: Gill, S., Brown, M., Robertson, F., Losseff, N. (eds) Stroke Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-6705-1_24
Download citation
DOI: https://doi.org/10.1007/978-1-4471-6705-1_24
Publisher Name: Springer, London
Print ISBN: 978-1-4471-6704-4
Online ISBN: 978-1-4471-6705-1
eBook Packages: MedicineMedicine (R0)