[A case of left atrial myxoma with repeated ischemia of left anterior cerebral artery territory].
A 52-year-old woman was admitted to our hospital because of paralysis of her right lower limb and dysarthria. After admission, she had exacerbations of paralysis of the right lower limb twice. Brain CT scan revealed a low density area in the left anterior cerebral artery territory. MRI disclosed the lesion of the body of the corpus callosum. On the fifth day, trans-esophageal echocardiography detected a mass lesion in the left atrium. There was no recurrence after treatment with heparin. On the 23rd day, the left atrial mass was removed surgically, which was elastic and soft and was confirmed to be myxoma pathologically. It was suggested that the embolic material originated from an adherent thrombus on the surface of the myxoma, since heparin was effective. She showed unique movements of her right hand like diagonistic dyspraxia. The right hand with mild paresis took away an object held in the left hand. The patient was able to move the right hand voluntarily and to imitate with it. She did not show grasping reflex, instinctive grasp reaction and apraxia of the left hand. The lesion of the body of corpus callosum may be responsible for this peculiar neurological symptom.
Hashimoto
Y
Y
Department of Neurology, Kumamoto City Hospital.
Misumi
K
K
Dohsaka
H
H
Kimura
K
K
Uchino
M
M
D002545:Brain Ischemia / Q000209:etiology*; D002536:Cerebral Arteries; D005260:Female; D006325:Heart Atria; D006338:Heart Neoplasms / Q000150:complications*; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology; D008875:Middle Aged; D009232:Myxoma / Q000150:complications*; D010243:Paralysis / Q000209:etiology