Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of cerebral embolism due to cardiac myxoma presenting with multiple cerebral microaneurysms detected on first MRI scans

Takahiro Sato, M.D.1)2), Naoki Saji, M.D.3), Kazuto Kobayashi, M.D.4), Kensaku Shibazaki, M.D.5) and Kazumi Kimura, M.D., Ph.D.2)

1)Department of Stroke Medicine, Kawasaki Medical School
2)Department of Neurological Science, Graduate School of Medicine, Nippon Medical School
3)Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology
4)Department of Neuroendovascular Therapy Medicine, Ise Red Cross Hospital
5)Department of Stroke Medicine, Jusendo Hospital

A 64-year-old man developed right arm weakness and dysarthria, and was admitted to our hospital. Diffusionweighted magnetic resonance imaging of the brain showed a high intensity area in the frontal lobe. T2*-weighted images showed multiple spotty low intensity lesions in bilateral cerebral hemispheres, mimicking cerebral microbleeds. Cerebral angiography showed multiple aneurysms in the anterior, middle, posterior cerebral arteries and cerebellar arteries. Transthoracic echocardiography revealed a floating structure in the left atrial chamber, indicating cardiac myxoma. We diagnosed cardioembolic ischemic stroke due to left atrial myxoma. Cardiac surgery for excision of a left atrial myxoma was performed on the 3rd hospital day. Multiple aneurysms should be taken into account for differential diagnosis in patients with cardiac myxoma and with atypical spotty low intensity on T2*-weighted images.
Full Text of this Article in Japanese PDF (702K)

(CLINICA NEUROL, 56: 98|103, 2016)
key words: myxoma, multiple aneurysms, cerebral embolism, T2*-weighted imaging

(Received: 28-Sep-15)