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Magnesium is the second most abundant intracellular cation, and is involved in a multitude of cellular enzymatic reactions that are essential for life. Hypomagnesemia has been associated with various neurological symptoms. We report an intriguing case of a 68-year-old woman with hypomagnesemia and cerebellar syndrome associated with a transient lesion of the cerebellar vermis selectively involving the nodulus. Immediate replacement of magnesium determined the reversibility of the clinical picture.

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We describe a case of a 34-year-old man with a sudden development of right hemiparesis and aphasia because of infarction of the left middle cerebral artery that was submitted to intravenous (IV) recombinant tissue plasminogen activator and mechanical thrombectomy. Transesophageal echocardiogram showed a small mass on the anterior leaflet of the mitral valve. Cardiac surgery was performed, and histological examination of the removed material was consistent with cardiac papillary fibroelastoma (CPF). Experience in using IV thrombolysis for the treatment of embolic stroke because of CPF is limited. To the best of our knowledge, only 3 patients are reported in literature in whom acute ischemic stroke and associated CPF were treated with thrombolytic therapy. A discussion of the efficacy of IV thrombolysis and the possible superiority of mechanical thrombectomy is included.

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