title: A large left atrial myxoma causing multiple cerebral infarcts.
abstract: A 52-year-old man presented with a history of sudden onset diplopia. On neurological examination, the only abnormality was a right-sided oculomotor (third nerve) palsy. A brain CT was performed and reported as showing no abnormality. He was discharged to be investigated as an outpatient. He presented 1 month later with a new expressive dysphasia and confusional state. MRI was performed which revealed multiple cerebral infarcts. He was discharged on secondary stroke prevention medication. Six months elapsed, before a transthoracic echocardiogram was performed. This showed a large left atrial myxoma. The patient underwent an emergency resection and made a good postoperative recovery. This case report showed the importance of considering a cardiogenic source of emboli in patients who present with cerebral infarcts. Performing echocardiography early will help to detect treatable conditions such as atrial myxoma, and prevent further complications.
authors.affiliation: Department of Medicine, Hywel Dda Health Board, Carmarthen, UK.
authors.forename: Saba
authors.initials: S
authors.lastname: Kebede
authors.forename: Eiry
authors.initials: E
authors.lastname: Edmunds
authors.forename: Adrian
authors.initials: A
authors.lastname: Raybould
mesh_terms: D002544:Cerebral Infarction / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D003937:Diagnosis, Differential; D004452:Echocardiography; D006338:Heart Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed