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Ischemic Stroke Induced by a Left Atrial Myxoma Sayaka Hatayama 1 , Toshiyasu Ogata 1 , Masakazu Okawa 1 , Toshio Higashi 1 , Tooru Inoue 1 , Koichi Takano 2 , Noritoshi Minematsu 3 , Tadashi Tashiro 3 , Noriyuki Sakata 4 1Department of Neurosurgery, Fukuoka University Faculty of Medicine 2Department of Radiology, Fukuoka University Faculty of Medicine 3Department of Cardiovascular Surgery, Fukuoka University Faculty of Medicine 4Department of Pathology, Fukuoka University Hospital Keyword: cardioembolic stroke , myxoma , anticoagulation , hemorrhagic transformation , recombinant tissue plasminogen activator pp.1175-1179
Published Date 2012/10/1
DOI https://doi.org/10.11477/mf.1416101323
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Abstract

 We reported a case of ischemic stroke induced by a left atrial myxoma. A 76-year-old man was found unconscious and transferred to the emergency ward in our hospital. He experienced consciousness disturbance, motor dominant aphasia, and severe right hemiparesis. His neurological and radiological findings indicated that he had ischemic stroke and was eligible to undergo intravenous thrombolysis. Alteplase was administrated 155 min after the onset of stroke. Intracerebral hemorrhage was not seen 24h after thrombolysis. A tumor in the left atrium was detected on transthoracic echocardiography, and this finding suggested that the tumor was a myxoma. Although cardiac surgery was scheduled, hemorrhagic transformation was found on day 11, which made us postpone the surgery. After the hemorrhage was disappeared, the tumor was resected by open-heart surgery and it was confirmed to be a myxoma. Neither his neurological symptom nor intracerebral hemorrhage was not deteriorated after the operation. Thrombolytic treatment seemed a safe option for ischemic stroke caused by left atrial myxoma. However, we should carefully monitor the extent of anticoagulation therapy because hemorrhagic transformation might alter the timing of surgery for tumor resection.

(Received: April 4, 2012, Accepted: April 12, 2012)


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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