Abstract
Background and purpose: Cardiac myxoma is a rare etiology of stroke. Both cerebral microbleeds and cardiac myxoma may increase the risk of intracerebral hemorrhage after intravenous (IV) thrombolysis. However, data are still limited. We report a case of multiple cerebral microbleeds treated with IV thrombolysis with later findings of cardiac myxoma.Summary of case: A 58-year-old-man presented with right-sided hemiplegia and global aphasia. The presumptive diagnosis of acute left middle cerebral artery (MCA) infarction was made. Previous magnetic resonance imaging showed multiple cerebral microbleeds. The patient received IV thrombolysis. Bilateral cerebellar hemorrhage occurred after thrombolysis, and a median suboccipital craniectomy and hematoma removal was performed. Transthoracic echocardiogram found a left atrial myxoma. The tumor was then surgically removed. Six months later, neurological deficit improved.Conclusion: Cerebral microbleeds may be associated with atrial myxoma. IV thrombolysis could benefit acute ischemic stroke patients with both baseline cerebral microbleeds and atrial myxoma.
Highlights
Cardiac myxoma is a rare etiology of stroke
Both cerebral microbleeds and cardiac myxoma may increase the risk of intracerebral hemorrhage (ICH) after IV thrombolysis [1,2,3,4]
We report a patient with multiple cerebral microbleeds who was treated with thrombolysis and was later found to have cardiac myxoma
Summary
Cardiac myxoma is a rare etiology of stroke. Both cerebral microbleeds and cardiac myxoma may increase the risk of intracerebral hemorrhage (ICH) after IV thrombolysis [1,2,3,4]. We report a patient with multiple cerebral microbleeds who was treated with thrombolysis and was later found to have cardiac myxoma. CASE REVIEW A 58-year-old Thai male with hypertension and previous ischemic stroke 4 months earlier, developed a sudden onset of right-sided weakness and was unable to speak 2 h prior to hospital arrival. His blood pressure was well controlled (
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