title: Surgical resection of left atrial myxoma presenting with acute multiple hemorrhagic cerebral infarctions: a case report.
abstract: Brain ischemia resulting from left atrial myxoma embolization has been well documented. In contrast, the link between the development of intracerebral hemorrhage and myxoma in these patients has little coverage in the literature. The main theory describing this relationship stems from the fact that cardiac myxoma cells metastasize to the brain's vessels, causing destruction of the arterial wall with subsequent formation of fusiform aneurysm and further intracranial bleeding. It is assumed that when a diagnosis of left atrial myxoma with neurologic manifestations is made, surgical resection should be performed without delay to prevent repeated tumor embolization; however, systemic anticoagulation treatment during cardiac surgery with cardiopulmonary bypass is not recommended immediately after intracerebral hemorrhage occurs because of the possibility of extending the infarct's size. We describe a patient with acute hemorrhagic brain infarction and an echocardiographically demonstrated left atrial myxoma that was surgically resected successfully in the acute phase after the onset of the neurologic symptoms.
authors.affiliation: Department of Cardiothoracic Surgery, E. Wolfson Medical Center, Holon, Israel.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Katz
authors.forename: Vitaly
authors.initials: V
authors.lastname: Finkelshtein
authors.forename: Dominique Ben-Ami
authors.initials: DB
authors.lastname: Raichman
authors.forename: Hagi
authors.initials: H
authors.lastname: Dekel
authors.forename: Yair
authors.initials: Y
authors.lastname: Lampl
authors.forename: Lior
authors.initials: L
authors.lastname: Sasson
mesh_terms: D013504:Cardiovascular Surgical Procedures / Q000379:methods; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000517:prevention & control*; D002544:Cerebral Infarction / Q000517:prevention & control* / Q000601:surgery*; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006338:Heart Neoplasms / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009232:Myxoma / Q000150:complications* / Q000601:surgery*; D016896:Treatment Outcome