Clinical Neuroscience

A rare aetiology of stroke; myxomatous aneurysm caused by atrial myxoma

ACAR Erkan1, OZDEMIR Zeynep1, SELCUK Hakan Hatem2, ÇOBAN Eda1, SOYSAL Aysun1

MARCH 30, 2018

Clinical Neuroscience - 2018;71(03-04)

DOI: https://doi.org/10.18071/isz.71.0141

Atrial myxoma is a rare cause of stroke. In this report we present the case of a 52-year-old female patient who went to hospital suffering from a headache. Her neurological examination was normal except for a positive Babinski sign on the left. In the superolateral of the right, a Sylvian fissure consistent with a thrombosed aneurysm was detected using computerised tomography (CT). Diffusion MRI showed an acute infarction on the right MCA area. Transthorasic Echocardiography and ECG were normal. A -16×4 mm-sized fusiform perpendicular aneurysm on the M2 segment Sylvian curve of right MCA and a -6×4 mm-sized dissecting aneurysm on P3 segment of the left posterior cerebral artery (PCA) were observed in cerebral angiography. Transesophageal echocardiography (TEE) demonsrated a large mass with a suspected size of 2×2×1.5 cm on the left atrium. The mass was resected and on the eighth day after the operation, she had a temporary vision loss and hyperintensity on the T1 sequence was interpreted as laminary necrosis suspected on Cranial MRI. In follow up, she was stable with 300mg acetylsalicylic acid treatment. The main treatment is surgical resection in stroke caused by atrial myxoma.

AFFILIATIONS

  1. Professor Mazhar Osman, Bakırköy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
  2. Dr Sadi Konuk, Bakırköy Training and Research Hospital, Istanbul, Turkey

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