Abstract
ObjectiveThe 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.MethodsData 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.ResultsYoung 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%.ConclusionCardiac 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.
Highlights
Cardioembolic stroke accounts for 14-30% of ischemic strokes with a predilection of early and later recurrences[1]
A comprehensive literature collection of cardiac myxoma stroke was made in PubMed, Google search engine and Highwire Press for the year range 2000-2014
The present study revealed young children at the age of 4 years can be a victim of cardiac myxoma stroke
Summary
Cardioembolic stroke accounts for 14-30% of ischemic strokes with a predilection of early and later recurrences[1]. Acute myocardial infarction, valvular heart disease, infective endocarditis and cardiac myxoma are major sources of cerebral emboli[2]. Atrial fibrillation is the most important one responsible for 45% of cardiogenic embolism[3]. The most common primary cardiac tumor, is a rare cause, but an important etiology as well for stroke in the young[4]. The diagnosis of a cardiac myxoma is often elusive in young stroke patients[5]. A delayed diagnosis and untimely treatment may mean laissez-faire of progression of stroke and development of certain critical consequences like systemic and peripheral embolic events. The clinical features of stroke of a cardiac myxoma origin 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
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