Summary
Neurological manifestations were analysed in 13 patients with left atrial myxoma confirmed by histological study. In this group, 6 patients had neurological complaints at initial presentation, 5 had cardiac symptoms, and 4 patients presented with signs of systemic disease. CT was performed in 10 and MRI in 7 patients. There were signs of ischaemic or haemorrhagic infarction (6 of 12) and one lesion suggestive of myxoma metastasis; other findings mainly comprised non-specific white matter lesions revealed by MRI. Neurological follow-up 0.5–8 years after tumour resection revealed no delayed neurological complications, follow-up CT and MRI findings were not suggestive of lesions acquired after operation. It is suggested that this rare condition of cardiac myxoma should be suspected in young patients with CNS symptoms or signs lacking cerebrovascular or cardiovascular risk factors and should be included in the differential diagnosis of vasculitis. With timely diagnosis and resection of the cardiac tumour the long-term prognosis can be considered improved.
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References
Barnett HJ (1983) Heart in ischemic stroke — a changing emphasis. Neurol Clin 1:291–315
Bazin A, Peruzzi P, Baudrillard JC, Pluot M, Rousseaux P (1987) Myxome cardiaque avec metastases cérébrales. Neurochirurgie 33:487–489
Branch CL Jr, Laster DW, Kelly DL Jr (1985) Left atrial myxoma with cerebral emboli. Neurosurgery 16:675–680
Buchanan RRC, Cairns JA, Kraag G, Robinson JG (1979) Left atrial myxoma mimicking vasculitis: echocardiographic diagnosis. Can Med Assoc J 120:1540–1542
Budzilovich G, Aleksic S, Greco A, et al (1979) Malignant cardiac myxoma with cerebral metastasis. Surg Neurol 11:461–469
Byrd WE, Mathews OP, Hunt RE (1980) Left atrial myxoma presenting as a systemic vasculitis. Arthritis Rheum 23:240–243
Calanchini PR (1979) Cardiac myxoma. In: Vinken PJ, Brunn BW (eds) Handbook of neurology, vol 38. North-Holland, Oxford, pp 173–192
Cerebral Embolism Task Force (1986) Cardiogenic brain embolism. Arch Neurol 43:71–84
Cogan DG, Wray SH (1975) Vascular occlusions in the eye from a cardiac myxoma. Am J Ophthalmol 80:394–403
DeSousa AL, Muller J, Campbell RL, Batnitzky S, Rankin L (1978) Atrial myxoma: a review of neurological complications, metastases and recurrence. J Neurol Neurosurg Psychiatry 41:1119–1124
Dizinger HG, Ringelstein EB (1985) Die Diagnostik des Schlaganfalles bei jungen Erwachsenen. Dtsch Med Wochenschr 110:1759–1765
Fitzpatrick AP, Lanham JG, Doyle DV (1986) Cardiac tumors simulating collagen vascular disease. Br Heart J 55:592–595
Frank RA, Shalen PR, Harvewy DG, et al (1979) Atrial myxoma with intellectual decline and cerebral growth on CT scan. Ann Neurol 5:396–400
Gonsalves CG, Nidecker AC (1979) Cerebral aneurysms and cardiac myxoma. Can Assoc Radiol J 30:127–128
Goodwin JF (1963) Diagnosis of left atrial myxoma. Lancet I:464–467
Hutson KA, Combs JJ, Lie JT, Giuliani ER (1978) Left atrial myxoma simulating peripheral vasculitis. Mayo Clin Proc 53:752–756
Kadota T, Imakita S, Mitomo M, Kawai R, Miura T, et al (1978) Metastatic brain tumor of atrial myxoma. Neuroradiology 29:218
Knepper LE, Biller J, Adams HP, Bruno A (1988) Neurologic manifestations of atrial myxoma. A 12-year experience and review. Stroke 19:1435–1440
Larsson S, Lepore V, Kennergren C (1989) Atrial myxomas: results of 25 years experience and review of the literature. Surgery 105:695–698
Leonhardt ETC, Kullenberg KPG (1977) Bilaterial atrial myxomas with multiple arterial aneurysms — a syndrome mimicking polyarteritis nodosa. Am J Med 62:792–794
MacGregor GA, Cullen RA (1959) The syndrome of fever, anemia, and high sedimentation rate with an atrial myxoma. BMJ 2:991–993
Markel ML, Armstrong WF, Waller BF, Mohamed Y (1986) Left atrial myxoma with multicentric recurrence and evidence of metastases. A case report. Am Heart J 111:409–413
Maroon JC, Campbell RL (1969) Atrial myxoma: a treatable cause of stroke. J Neurol Neurosurg Psychiatry 32:129–133
Marvasti MA, Obeid AI, Putts SL, Parker FB (1984) Approach in the management of atrial myxoma with long-term follow-up. Ann Thorac Surg 38:53–58
Metz-Kurschel U, Wehr M (1989) Vorhofmyxom und Zeichen einer Autoimmunerkrankung. Dtsch Med Wochenschr 114:181–183
Michael AS, Mikhael MA, Christ M (1989) Myxoma of the heart presenting with recurrent episodes of hemorrhagic cerebral infarction. MR findings. J Comput Assist Tomogr 13:123–125
Moore PM, Cupps TR (1983) Neurological complications of vasculitis. Ann Neurol 14:155–167
Morimoto K, Fujita T, Wakayama A, Myazaki Y, et al (1986) Cardiac myxoma metastatic to the brain (English abstract). No To Shinkei 38:865–869
New PFJ, Price DL, Carter B (1970) Cerebral angiography and histological findings. Radiology 96:335–345
Olmstedt WW, McGee TP (1977) The pathogenesis of peripheral aneurysms of the central nervous system. A subject review from the AFIP. Radiology 132:661–666
Peters MN, Hall RJ, Cooley DA, Leachman RD, et al (1974) The clinical syndrome of atrial myxoma. JAMA 230:695–700
Rankin AI, DeSousa AL (1978) Metastatic atria] myxoma presenting as an intracranial mass. Chest 74:451–460
Richardson JV, Brandt B, Doty DB, Ehrenhaft JL (1979) Surgical treatment of atrial myxomas: early and late results of 11 operations and review of the literature. Ann Thorac Surg 28:354–358
Roeltgen DP, Weimer GR, Patterson LF (1981) Delayed neurologic complications of left atrial myxoma. Neurology 31:8–13
Rozear MP, Wolfe WG (1985) An unusual cause of recurrent transient neurologic deficit. N C Med J 46:399
Sandok BA, Estorff IV, Giuliani ER (1980) Subsequent neurological events in patients with atrial myxoma. Ann Neurol 8:305–307
Savige JA, Yeung SP, Davies DJ, Ebeling P, et al (1988) Antineutrophil cytoplasmatic antibodies associated with atrial myxoma (Letter). Am J Med 85:755–756
Schwartz GA, Schwartzman RJ, Joyner CR (1972) Atrial myxoma, cause of embolic storke. Neurology 22:1112–1121
Sherman DG, Dyken ML, Fisher M, Harrison L, Hart RG (1986) Cerebral embolism. Chest 89[Suppl 2]:82–98
Sigal LH (1987) The neurology of vasculitis and rheumatologic syndromes. A review. Medicine (Baltimore) 66:157–180
Snyder BD, Ramirez-Lassepas M (1980) Cerebral infarction in young adults. Stroke 11:149
Steinmetz EF, Calanchini PR, Aguilar MJ (1973) Left atrial myxoma as a neurological problem. A case report and review. Stroke 4:451–458
Thomas MH (1981) Myxoma masquerading as polyarteritis nodosa. J Rheumatol 8:133–137
Thompson J, Kapoor W, Wechsler LR (1988) Multiple strokes due to atrial myxoma with negative echocardiogram. Stroke 19:1570–1571
Tipton BK, Robertson JT, Robertson JH (1977) Embolus to the central nervous system form cardiac myxoma. Report of two cases. J Neurosurg 47:937–940
Yufe R, Karpati G, Carpenter S (1976) Cardiac myxoma: a diagnostic challenge for the neurologist. Neurology 26:1060–1065
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Reichmann, H., Romberg-Hahnloser, R., Hofmann, E. et al. Neurological long-term follow-up in left atrial myxoma: Are late complications frequent or rare?. J Neurol 239, 170–174 (1992). https://doi.org/10.1007/BF00833920
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DOI: https://doi.org/10.1007/BF00833920