[Myxoma of the mitral valve with embolization of the posterior circulation. A case report and review of the literature].
BACKGROUND
Although cardiac tumours are infrequent, over half are myxomas. Most are situated in the cavities of the heart and exceptionally on the valves. Embolism towards the arteries of the anterior circulation of the central nervous system is the commonest neurological finding, but rarely involves the posterior circulation.


METHODS
A 79 year old woman who one year before admission had had a right hemiparesia of the face and body, from which she had made a complete recovery. Three months later she had a sudden onset of unsteady gait which was deviated towards the right and vertigo. She attended our institution where magnetic resonance (MR) studies showed that there were infarcts in the territory of the right anterior and posterior inferior cerebellar arteries. Four months later she had a further episode of unsteady gait, vertigo and right hemiparesia of face and body for which she was admitted to hospital. On physical examination there was dysmetry, dysdiadokokinesia and involvement of the third cranial nerve. Further MR studies showed the previous lesions and also a new ischaemic lesion of the mesencephalum. A transoesophagic echocardiogram showed a tumour of approximately 18 x 20 mm, implanted in the mitral valve. Study of the resected tumour showed it to be a myxoma. Six months later the patient was asymptomatic and had not relapsed.


CONCLUSIONS
Although the association of vascular events of the posterior circulation with myxomas of the mitral valve is rare, its clinical importance cannot be overlooked.
Remes Troche
J M
JM
Dpto. de Medicina Interna; Instituto Nacional de Ciencias Médicas y de la Nutrición Salvador Zubirán, México DF, 14000, México.
Zuñiga
J
J
Rebollar
V
V
Hernández
P
P
Narváez
R
R
Téllez Zenteno
J F
JF
García Ramos
G
G
D000368:Aged; D002560:Cerebrovascular Circulation; D004452:Echocardiography; D005260:Female; D006338:Heart Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008943:Mitral Valve / Q000473:pathology* / Q000503:physiopathology; D009232:Myxoma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology
Mixoma de la válvula mitral con embolización a circulación posterior. Descripción de un caso y revisión de la literatura.