title: Effective mechanical thrombectomy in a patient with hyperacute ischemic stroke associated with cardiac myxoma.
abstract: Ischemic stroke is the most common neurologic manifestation of cardiac myxoma. However, there has been no current guideline on the treatment of hyperacute ischemic stroke due to cardiac myxoma. We describe a patient with hyperacute stroke caused by cardiac myxoma who had a good outcome with rapid recanalization through mechanical thrombectomy. A 46-year-old man was admitted with acute symptoms of right side hemiplegia and global aphasia. Brain computed tomography (CT) angiography showed a T occlusion of the left internal carotid artery. Intravenous recombinant tissue plasminogen activator was administered. However, his clinical symptoms did not improve. Thus, we performed endovascular treatment and had a successful outcome. A pathologic examination of the retrieved clot revealed a tumor emboli from a cardiac myxoma. Transthoracic echocardiogram revealed a left atrial myxoma in which a large mass was attached to the posterior wall of the aorta. The patient's neurologic deficits recovered with the exception of left eye blindness. Reperfusion therapy with mechanical thrombectomy might be safe and effective for the rapid revascularization of large vessel occlusions in hyperacute ischemic stroke, from which the tumor thrombi can be retrieved.
authors.affiliation: Department of Neurology, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seol-Hee
authors.initials: SH
authors.lastname: Baek
authors.affiliation: Department of Radiology, Korea University College of Medicine, Seoul, Republic of Korea; Department of Radiology, School of Medicine, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
authors.forename: Soonchan
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Radiology, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Nam Joon
authors.initials: NJ
authors.lastname: Lee
authors.affiliation: Department of Pathology, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Youngjin
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Department of Neurology, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: kh.cho.neuro@gmail.com.
authors.forename: Kyung-Hee
authors.initials: KH
authors.lastname: Cho
mesh_terms: D002545:Brain Ischemia / Q000209:etiology* / Q000601:surgery*; D006338:Heart Neoplasms / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000150:complications* / Q000473:pathology; D020521:Stroke / Q000209:etiology* / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology
keywords: Ischemic stroke; cardiac myxoma; clinical outcome; emboli; mechanical thrombectomy; recanalization