Cranial MRI and CT in patients with left atrial myxoma

Hofmann, Erich; Becker, Thomas; Romberg-Hahnloser, R.; Reichmann, Heinz; Warmuth‐Metz, Monika; Nadjmi, M

doi:10.1007/bf00588434

Cited by 25 publications

(11 citation statements)

References 37 publications

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“…Similar to a number of prior studies, the most common neurological manifestation of cardiac myxoma in our series was cerebral infarction [2,3,5,11] . Cardiac myxomas have been reported to cause 0.5% of cerebral infarctions and up to 30% of myxoma patients present with systemic or cerebral emboli [12] .…”

Section: Ischemic Strokes In Myxoma Patientssupporting

confidence: 71%

Neuroimaging Findings in Cardiac Myxoma Patients: A Single-Center Case Series of 47 Patients

Brinjikji

Morris²,

Brown³

et al. 2015

Cerebrovasc Dis

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Background and Purpose: Cardiac myxomas can present with a myriad of neurological complications including stroke, cerebral aneurysm formation and metastatic disease. Our study had two objectives: (1) to describe the neuroimaging findings of patients with cardiac myxomas and (2) to examine the relationship between a history of embolic complications secondary to myxoma and intracranial aneurysm formation, hemorrhage and metastatic disease. We hypothesized that patients who present with embolic complications related to myxoma would be more likely to have such complications. Materials and Methods: We searched our institutional database for all patients with pathologically proven cardiac myxomas from 1995 to 2014 who received neuroimaging. Neuroimaging findings were categorized as acute ischemic stroke, intracerebral hemorrhage, oncotic aneurysm, and cerebral metastasis. Cardiac myxoma patients were divided into those presenting with embolic complications (i.e. lower extremity emboli or cerebral emboli) and those presenting with non-embolic complications prior to surgical resection of the myxoma. The prevalence of intracranial hemorrhage, myxomatous aneurysm formation, and cerebral metastases was compared in myxoma patients presenting with and without embolic complications using a Chi-squared test. Results: Forty-seven consecutive patients were included in this study. Sixteen patients (34.0%) had imaging evidence of acute ischemic stroke. Of these, 13 had acute ischemic strokes directly attributed to the cardiac myxoma (27.7%) and 3 had acute ischemic strokes secondary to causes other than myxoma (6.4%). Seven patients (14.9%) had aneurysms. Two patients (4.3%) had parenchymal metastatic disease on long-term imaging. Fourteen patients (29.8%) presented with ischemic symptoms that were attributed to cardiac myxoma (1 with lower extremity ischemia, 1 with lower extremity ischemia and ischemic stroke, and 12 with ischemic stroke). Patients presenting with embolic complications related to the myxoma (ischemic stroke or lower extremity ischemia) were more likely to have imaging evidence of intracranial hemorrhage (21.4 vs. 3.0%, p = 0.09), oncotic aneurysm (35.7 vs. 6.1%, p = 0.03), and cerebral metastasis (14.3 vs. 0.0%, p = 0.07) on follow-up imaging. Conclusions: Ischemic stroke and intracranial oncotic aneurysm were found in a substantial proportion of cardiac myxoma patients undergoing neuroimaging. Patients presenting with embolic complications of cardiac myxoma are more likely to have intracranial hemorrhage, intracranial oncotic aneurysms, and cerebral metastatic disease.

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Section: Ischemic Strokes In Myxoma Patientssupporting

confidence: 71%

Neuroimaging Findings in Cardiac Myxoma Patients: A Single-Center Case Series of 47 Patients

Brinjikji

Morris²,

Brown³

et al. 2015

Cerebrovasc Dis

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“…It is necessary to remove the cardiac mass when discovered after neurological symptoms to prevent further emboli, but cardiac surgery cannot abolish the risk of delayed cerebral aneurysm formation and metastatic myxoma. In some cases, aneurysms appear after resection of the primary myxoma, presumably as a result of metastatic seeding prior to surgery 1,4,13,21,22 , and are responsible for delayed neurological syntoms up to 25 years after resection 9,23 .…”

Section: Discussionmentioning

confidence: 99%

Multiple Cerebral Aneurysms Associated with Atrial Myxoma

et al. 2010

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Cardiac myxoma is a tumor of mesenchymal origin accounting for half of all primary cardiac neoplasms. Intracranial involvement by atrial myxoma is a rare cause of neurologic deficit. When the myxoma arises in the left atrium, systemic emboli from a cardiac myxoma can lead to infarction, cerebral hemorrhage and aneurysm formation. In the light of the potentially preventable nature of these lesions, the diagnosis of myxomatous aneurysms should be considered in any patient with neurologic symptoms and a history of cardiac myxoma. Because aneurysms are often stable over several years, conservative management with careful clinical and radiological follow-up with MRI and angiography seems sensible. We describe a case in which MR imaging and angiography were used to diagnose multiple cerebral aneurysms caused by left atrial myxoma.

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“…Serebral imaging expecially MRI of the brain is the most useful modality to demonstrate ischemic lesions at the early phase of stroke. The typical finding of MRI of the brain is multible infarcts expecially on the MCA territory [10].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Embolization of a Left Atrial Myxoma Resulting in Acute Cerebral Ischemia

Gunduz¹

2011

J Clinic Experiment Cardiol

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Cranial MRI and CT in patients with left atrial myxoma

Cited by 25 publications

References 37 publications

Neuroimaging Findings in Cardiac Myxoma Patients: A Single-Center Case Series of 47 Patients

Neuroimaging Findings in Cardiac Myxoma Patients: A Single-Center Case Series of 47 Patients

Multiple Cerebral Aneurysms Associated with Atrial Myxoma

Recurrent Embolization of a Left Atrial Myxoma Resulting in Acute Cerebral Ischemia

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