Madalena Rosário1, Ana Catarina Fonseca1,2, Filipa Dourado Sotero1, José M Ferro3,4. 1. Department of Neurosciences and Mental Health, Neurology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal. 2. Faculdade de Medicina, Hospital de Santa Maria, Universidade de Lisboa, Neurology 6th floor, Avenida Professor Egas Moniz s/n, 1649-035, Lisbon, Portugal. 3. Department of Neurosciences and Mental Health, Neurology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal. jmferro@medicina.ulisboa.pt. 4. Faculdade de Medicina, Hospital de Santa Maria, Universidade de Lisboa, Neurology 6th floor, Avenida Professor Egas Moniz s/n, 1649-035, Lisbon, Portugal. jmferro@medicina.ulisboa.pt.
Abstract
PURPOSE OF REVIEW: This article reviews recent literature regarding the neurological manifestations of cardiac tumors, including diagnosis, pathophysiology, and treatment. RECENT FINDINGS: Clinical cases of patients with acute ischemic stroke due to cardiac tumors who were treated with intravenous alteplase show a favorable safety profile. Mechanical thrombectomy seems to be a reasonable treatment alternative for these patients, when there is a large vessel occlusion. Histopathology analysis of mechanical thrombectomy specimens may allow the diagnosis of a cardiac tumor. Prolonged time interval between stroke and tumor excision surgery is significantly associated with stroke recurrence. Myxomatous aneurysms are a late complication of cardiac myxomas, which commonly demand imaging follow-up after excision of the primary tumor. Aneurysms are more frequent in patients who present with other embolic complications. Conservative treatment of myxomatous aneurysms is a reasonable strategy, as the majority of aneurysms remain stable over many years. Spontaneous regression of these formations has been documented after excision of the primary tumor. Other complications recently described include acute psychosis and mononeuropathy multiplex. Cardiac tumors are rare. There are mainly case reports and retrospective case series describing the neurological manifestations of cardiac tumors. Hyperacute stroke treatment seems to be safe, and mechanical thrombectomy is a reasonable treatment. A conservative approach towards myxomatous aneurysms should be considered.
PURPOSE OF REVIEW: This article reviews recent literature regarding the neurological manifestations of cardiac tumors, including diagnosis, pathophysiology, and treatment. RECENT FINDINGS: Clinical cases of patients with acute ischemic stroke due to cardiac tumors who were treated with intravenous alteplase show a favorable safety profile. Mechanical thrombectomy seems to be a reasonable treatment alternative for these patients, when there is a large vessel occlusion. Histopathology analysis of mechanical thrombectomy specimens may allow the diagnosis of a cardiac tumor. Prolonged time interval between stroke and tumor excision surgery is significantly associated with stroke recurrence. Myxomatous aneurysms are a late complication of cardiac myxomas, which commonly demand imaging follow-up after excision of the primary tumor. Aneurysms are more frequent in patients who present with other embolic complications. Conservative treatment of myxomatous aneurysms is a reasonable strategy, as the majority of aneurysms remain stable over many years. Spontaneous regression of these formations has been documented after excision of the primary tumor. Other complications recently described include acute psychosis and mononeuropathy multiplex. Cardiac tumors are rare. There are mainly case reports and retrospective case series describing the neurological manifestations of cardiac tumors. Hyperacute stroke treatment seems to be safe, and mechanical thrombectomy is a reasonable treatment. A conservative approach towards myxomatous aneurysms should be considered.
Authors: Waleed Brinjikji; Jonathan M Morris; Robert D Brown; Kent R Thielen; John T Wald; Caterina Giannini; Harry J Cloft; Christopher P Wood Journal: Cerebrovasc Dis Date: 2015-06-10 Impact factor: 2.762
Authors: Prakash Aroor Sarvotham Rao; S N Nagendra Prakash; Somanath Vasudev; M Girish; Arun Srinivas; H P Guru Prasad; P Jayakumar; Venu Gopal Anandaswamy Journal: Indian Heart J Date: 2016-05-21
Authors: Alina Costina Luca; Ingrith Crenguța Miron; Elena Cojocaru; Elena Țarcă; Alexandrina-Stefania Curpan; Doina Mihăila; Laura Mihaela Trandafir; Alin-Constantin Iordache; Vasile-Valeriu Lupu; Henry D Tazelaar; Ioana Alexandra Pădureț Journal: Children (Basel) Date: 2022-06-23