Cerebral embolism from atrial myxoma in pediatric patients.
We describe 2 children with cerebrovascular events caused by emboli from left atrial myxomas and review 7 other pediatric cases from the literature. Transient cutaneous eruptions involving the extremities preceded the cerebrovascular events and were most likely attributable to fragmentation of the atrial tumor with peripheral embolization. Our first case demonstrates the more common presentation with acute hemiplegia caused by cerebral infarction and the second case a transient ischemic attack manifested by more subtle features as a result of involvement of the vertebrobasilar circulation. Neither child had a history or other signs of cardiac disease. Atrial myxoma should be considered in the differential diagnosis when children present with neurologic symptoms or with signs of embolization, because surgical removal of the tumor is critical and may be curative.
Al-Mateen
Majeed
M
Pediatric Neurology Clinic, Mary Bridge Children's Hospital and Health Center, Tacoma, Washington 98415, USA. majeed.al-mateen@muticare.org
Hood
Margaret
M
Trippel
Don
D
Insalaco
Samuel J
SJ
Otto
Randolph K
RK
Vitikainen
Kari J
KJ
D002648:Child; D003937:Diagnosis, Differential; D004617:Embolism / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006338:Heart Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D006429:Hemiplegia / Q000209:etiology*; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology*; D002546:Ischemic Attack, Transient / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D009232:Myxoma / Q000150:complications* / Q000000981:diagnostic imaging; D012871:Skin Diseases / Q000175:diagnosis / Q000209:etiology; D014463:Ultrasonography