title: Cardiac papillary fibroelastoma: source of cerebral embolism treated with intravenous thrombolysis.
abstract: We present the case of a 41-year-old man with sudden development of left hemiparesis due to infarction of the right middle cerebral artery that was successfully treated with intravenous (IV) thrombolysis with alteplase. Transthoracic echocardiography showed a small mass in the left ventricle. The patient underwent surgical resection, and histological examination of the mass confirmed the diagnosis of papillary fibroelastoma. It remains to be investigated whether heart ultrasound evaluation should be performed before IV thrombolysis in selected patients with stroke, given the apparently increased risk of bleeding. However, IV thrombolysis should not be postponed due to a lengthy investigation, because of its potential for reducing morbidity in patients with stroke.
authors.affiliation: Department of Neurology, University Hospital Center, Zagreb, Croatia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Matijević
authors.forename: Zdravka
authors.initials: Z
authors.lastname: Poljaković
authors.forename: Ivana
authors.initials: I
authors.lastname: Ilić
authors.forename: Ivo
authors.initials: I
authors.lastname: Cikeš
authors.forename: Mario
authors.initials: M
authors.lastname: Habek
mesh_terms: D000328:Adult; D001706:Biopsy; D004452:Echocardiography; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005350:Fibroma / Q000150:complications* / Q000175:diagnosis; D006338:Heart Neoplasms / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007262:Infusions, Intravenous; D020766:Intracranial Embolism / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D010291:Paresis / Q000209:etiology; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator