title: Multiple cerebral myxomatous aneurysms: what is the optimal treatment?
abstract: BACKGROUND
  Multiple cerebral aneurysms resulting from cardiac myxoma is a very rare disease, and the optimal treatment is not yet determined. We present 2 cases of multiple cerebral myxomatous aneurysms and give an overview of the English literature pertaining to this disease.
  
  
  METHODS
  We described 2 new cases of multiple cerebral myxomatous aneurysms and performed a search of English literature in PubMed and Google Scholar. Keywords used were as follows (single word or combination): "neoplastic aneurysm," "oncotic aneurysm," "aneurysm," and "myxoma." Only patients with multiple cerebral aneurysms resulting from cardiac myxoma and contained adequate follow-up information pertinent to the analysis were included.
  
  
  RESULTS
  One patient underwent craniotomy for resection of an aneurysm. Microscopic examination demonstrated the myxoma in the aneurysmal wall. The other patient was managed conservatively. Thirty-five cases meeting the previously mentioned criteria were found in the literature. This disease was typically diagnosed in young adults (median age = 38 years). Females were more frequently affected (F/M ratio, 2.7:1). A total of 78.4% were managed conservatively. A total of 16.2% underwent craniotomy for aneurysm resection and/or hematoma evacuation. At follow-up, 64.9% were stable, 10.8% revealed disappearance of aneurysms, 10.8% showed enlargement of aneurysms, and the mortality rate was 13.5%.
  
  
  CONCLUSIONS
  Patients with multiple cerebral aneurysms should routinely be evaluated for cardiac myxoma and vice versa. Conservative treatment is recommended for most of the patients. Prognosis is good in most patients.
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Shuo
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: ronger090614@yahoo.cn.
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: zhaojz205@hotmail.com.
authors.forename: Jizong
authors.initials: J
authors.lastname: Zhao
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000150:complications* / Q000601:surgery / Q000628:therapy*; D002544:Cerebral Infarction / Q000150:complications / Q000473:pathology; D003399:Craniotomy; D005260:Female; D006338:Heart Neoplasms / Q000473:pathology; D006801:Humans; D002532:Intracranial Aneurysm / Q000209:etiology* / Q000601:surgery / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D009232:Myxoma / Q000150:complications* / Q000601:surgery / Q000628:therapy*; D009460:Neurologic Examination; D019635:Neurosurgical Procedures / Q000379:methods; D011379:Prognosis
keywords: Myxomatous aneurysms; cardiac myxoma; conservative; management; multiple