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Neurological Complications of Cardiac Tumors

  • Madalena Rosário
  • Ana Catarina Fonseca
  • Filipa Dourado Sotero
  • José M. FerroEmail author
Neurology of Systemic Diseases (J. Biller, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Neurology of Systemic Disease

Abstract

Purpose of Review

This article reviews recent literature regarding the neurological manifestations of cardiac tumors, including diagnosis, pathophysiology, and treatment.

Recent Findings

Clinical cases of patients with acute ischemic stroke due to cardiac tumors who were treated with intravenous alteplase show a favorable safety profile. Mechanical thrombectomy seems to be a reasonable treatment alternative for these patients, when there is a large vessel occlusion. Histopathology analysis of mechanical thrombectomy specimens may allow the diagnosis of a cardiac tumor. Prolonged time interval between stroke and tumor excision surgery is significantly associated with stroke recurrence. Myxomatous aneurysms are a late complication of cardiac myxomas, which commonly demand imaging follow-up after excision of the primary tumor. Aneurysms are more frequent in patients who present with other embolic complications. Conservative treatment of myxomatous aneurysms is a reasonable strategy, as the majority of aneurysms remain stable over many years. Spontaneous regression of these formations has been documented after excision of the primary tumor. Other complications recently described include acute psychosis and mononeuropathy multiplex.

Summary

Cardiac tumors are rare. There are mainly case reports and retrospective case series describing the neurological manifestations of cardiac tumors. Hyperacute stroke treatment seems to be safe, and mechanical thrombectomy is a reasonable treatment. A conservative approach towards myxomatous aneurysms should be considered.

Keywords

Cardiac tumors Stroke Aneurysms Fibroelastoma Myxoma 

Notes

Compliance with Ethical Standards

Conflict of Interest

Jose Ferro reports grants from Bayer, personal fees from Boehringer Ingelheim, outside the submitted work. Madalena Rosário, Filipa Dourado Sotero and Ana Catarina Fonseca each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Madalena Rosário
    • 1
  • Ana Catarina Fonseca
    • 1
    • 2
  • Filipa Dourado Sotero
    • 1
  • José M. Ferro
    • 1
    • 2
    Email author
  1. 1.Department of Neurosciences and Mental Health, Neurology Service, Hospital de Santa MariaCentro Hospitalar Universitário Lisboa NorteLisbonPortugal
  2. 2.Faculdade de Medicina, Hospital de Santa MariaUniversidade de LisboaLisbonPortugal

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