An unexpected cause of a recurrent cerebral hemorrhage.
A 4-year-old previously healthy boy presented with a non-traumatic right parietal hemorrhage. A second life-threatening left cerebral hemorrhage occurred three weeks later and was decompressed with a craniotomy. Transthoracic echocardiography revealed a hypermobile elongated tumor of the mitral valve. The cardiac tumor was successfully resected three weeks after the craniotomy. Histological examination of the cardiac tumor revealed a papillary lesion of spindle cells with smooth muscle cell differentiation. In view of the histological findings and the clinical symptoms, a cellular myofibroblastic tumor was considered the most likely diagnosis in our patient. Although a cardiac tumor is a rare cause of a cerebral hemorrhage, a cardiac evaluation is recommended in pediatric patients with a cerebral hemorrhage of unknown etiology.
Thijs
R D
RD
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. r.d.thijs@lumc.nl
Hazekamp
M G
MG
Rijlaarsdam
M E
ME
Willems
S M
SM
Schutte
P J
PJ
Laan
L A E M
LA
D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000473:pathology*; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods; D006338:Heart Neoplasms / Q000150:complications* / Q000473:pathology* / Q000648:ultrastructure; D006801:Humans; D008297:Male; D012008:Recurrence; D014057:Tomography, X-Ray Computed / Q000379:methods