Systematic Review and Case of Thrombectomy for Pediatric Stroke Due to Myxoma Embolism

Abstract

BackgroundStroke presentation secondary to a cardiac myxoma thromboembolism are rare in the pediatric population. Because of its rarity, the reported cases in the literature are primarily case reports. Additionally, general pediatric stroke management lacks evidence-based guidelines because of its low incidence and lack of clinical trials. In pediatric strokes identified from a cardiac myxoma, the incidence favors boys with classical presentation of unilateral weakness and aphasia. We present a pediatric patient who presented with stroke-like symptoms secondary to an intracranial embolus from a previously undiagnosed cardiac myxoma. MethodsWe performed a systematic review by searching PubMed, Google Scholar, Web of Science, and Embase databases for cases of pediatric myxoma causing stroke (n=2431) and identified 19 reported uses of surgical management in treating pediatric patients who present with stroke symptoms secondary to a cardiac myxoma thromboembolism. ResultsThe most common imaging modality was MRI in 42% of cases, CT in 36.8%, followed by CTA in 31.6% of cases. Of these 19 children treated with procedures, 36.8% of pediatric patients aged between 4 and 14 years underwent neurosurgery (n=7). ConclusionsWe describe an urgent mechanical thrombectomy, share preoperative and postoperative images and pathology slides confirming a stroke from myxoma origin. We provide added insight in the safe use of mechanical thrombectomy as treatment for pediatric strokes secondary to a thromboembolism.