title: [Ischemic stroke induced by a left atrial myxoma].
abstract: We reported a case of ischemic stroke induced by a left atrial myxoma. A 76-year-old man was found unconscious and transferred to the emergency ward in our hospital. He experienced consciousness disturbance, motor dominant aphasia, and severe right hemiparesis. His neurological and radiological findings indicated that he had ischemic stroke and was eligible to undergo intravenous thrombolysis. Alteplase was administrated 155 min after the onset of stroke. Intracerebral hemorrhage was not seen 24h after thrombolysis. A tumor in the left atrium was detected on transthoracic echocardiography, and this finding suggested that the tumor was a myxoma. Although cardiac surgery was scheduled, hemorrhagic transformation was found on day 11, which made us postpone the surgery. After the hemorrhage was disappeared, the tumor was resected by open-heart surgery and it was confirmed to be a myxoma. Neither his neurological symptom nor intracerebral hemorrhage was not deteriorated after the operation. Thrombolytic treatment seemed a safe option for ischemic stroke caused by left atrial myxoma. However, we should carefully monitor the extent of anticoagulation therapy because hemorrhagic transformation might alter the timing of surgery for tumor resection.
authors.affiliation: Department of Neurosurgery, Fukuoka University , Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Hatayama
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Ogata
authors.forename: Masakazu
authors.initials: M
authors.lastname: Okawa
authors.forename: Toshio
authors.initials: T
authors.lastname: Higashi
authors.forename: Tooru
authors.initials: T
authors.lastname: Inoue
authors.forename: Koichi
authors.initials: K
authors.lastname: Takano
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Minematsu
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tashiro
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Sakata
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000188:drug therapy*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000601:surgery; D006325:Heart Atria / Q000601:surgery*; D006338:Heart Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D009232:Myxoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D015912:Thrombolytic Therapy / Q000009:adverse effects; D016896:Treatment Outcome