Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7572
Peer-review started: March 31, 2021
First decision: May 11, 2021
Revised: May 24, 2021
Accepted: July 21, 2021
Article in press: July 21, 2021
Published online: September 6, 2021
Cardiac embolism is a common cause of ischemic stroke in young adults. Neurological complications associated with atrial myxoma most frequently include cerebral infarct due to embolus. Early complete resection of giant cardiac myxoma is the key to its treatment and prevention of stroke recurrence.
A 42-year-old, previously healthy woman was admitted to the hospital with sudden-onset inability to speak and right-sided hemiplegia. While sweeping the floor 2 h prior to hospital admission, the patient developed sudden inability to express herself or understand what others were saying, accompanied by dyskinesia of the right limb, inability to walk or hold objects, and involuntary choreiform movements of the left upper limb. The patient was diagnosed with cerebral embolism and cardiac myxoma, complicated by left middle cerebral artery occlusion. The acute stroke was treated with intravenous thrombolytic therapy and arterial embolectomy as a bridging therapy to open resection of left atrial cardiac myxoma. The patient condition improved remarkably following initial thrombolysis and embolectomy and subsequently underwent emergency open resection of the atrial cardiac myxoma. She had no recurrence during 1-year follow-up.
Strong consideration should be given to urgent intravenous thrombolysis (rt-PA, alteplase) in young adult stroke patients at the time of hospital admission. The present case demonstrated a highly successful outcome that combined throm
Core Tip: The incidence of ischemic stroke caused by cardiac mucinous tumors has been reported both nationally and internationally. Still, it is rarely reported that intravenous thrombolytic bridging artery retrieval with same-day open thoracotomy for left atrial mucinous tumors is performed in the early stage of stroke. We treated a case with cerebral embolic stroke associated with cardiac myxoma, the embolus was successfully removed, and the cardiac tumor was extirpated surgically on the day of presentation.