Abstract
Background
Ischemic stroke in the pediatric population is a rare occurrence, and its possible
causes span a wide differential that includes atrial myxomas. Myxomas are friable
cardiac tumors that produce “showers” of emboli resulting in transient neurological
deficits, cutaneous eruptions, and ophthalmologic deficits.
Patient
We present an 11-year-old boy with a months-long history of an intermittent spotted
“rash” who presented with acute ischemic stroke caused by a left atrial myxoma. We
also review clinical features in all 16 other cases of cardiac myxoma causing pediatric
stroke reported in the literature.
Results
Our case, along with the review of the literature, highlights the fact that myxomas
often initially present as stroke with acute hemiplegia and transient cutaneous eruptions
due to fragmentation of the tumor.
Conclusions
Cardiac myxoma should be considered in any child presenting with ischemic stroke,
and transient skin findings may provide an important diagnostic clue prior to onset
of neurological symptoms.
Keywords
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References
- Management of Stroke in Infants and Children: a Scientific Statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young.Stroke. 2008; 39: 2644-2691
- Seizures associated with stroke in childhood.Pediatr Neurol. 1995; 12: 136-138
- Cerebral embolism from atrial myxoma in pediatric patients.Pediatrics. 2003; 112: e162-e167
- A left atrial myxoma presenting as a cerebrovascular accident.Pediatr Neurol. 1999; 21: 569-572
- Neurologic manifestations of atrial myxoma: a 12 year experience and review.Stroke. 1988; 19: 1435-1440
- Left atrial myxoma in a child: case report and review of the literature.Cardiovasc Pathol. 2003; 12: 233-236
- Primary cardiac myxosarcoma in a child.Mayo Clin Proc. 1979; 54: 261-266
- Recurrent left atrial myxoma with recurrent stroke.Indian Pediatr. 2001; 38: 1190-1192
- Embolism to the central nervous system from cardiac myxoma: report of two cases.J Neurol. 1977; 47: 927-940
- Intracranial aneurysms in a child with recurrent atrial myxoma.Pediatr Neurol. 1987; 3: 230-232
- Convulsions, hemiparesis and central retinal artery occlusion due to left atrial myxoma in a child.Eur J Pediatr. 1992; 151: 652-654
- Multiple cerebral aneurysms in a child with cardiac myxoma.J Formos Med Assoc. 1992; 91: 818-821
- Myxoma of the left atrium: diagnosis made during life with operative and post-mortem findings.Circulation. 1952; 6: 762-767
- Embolic strokes in an 8-year-old girl.Neurology. 2000; 55: 146
- Left atrial myxoma in a child: a challenging diagnosis of a rare lesion.World J Pediatr Congenit Heart Surg. 2013; 4: 220-222
- Cerebrovascular stroke as a sign of atrial myxoma in childhood [in Spanish].An Pediatr (Barc). 2003; 58: 273-276
- Recurrent left atrial myxomas in carney complex: a genetic cause of multiple strokes that can be prevented.J Stroke Cerebrovasc Dis. 2012; 21: 914.e1-914.e8
- Left atrial myxomas in childhood: presentation with emboli – diagnosis by ultrasonics.Thorax. 1972; 27: 759-763
- Myxoma of the left atrium – case report.CMAJ. 1960; 83: 715-717
- Cardiac myxomas.N Engl J Med. 1995; 333: 1610-1617
- Multiple cerebral aneurysms caused by cardiac myxoma.Interv Neuroradiol. 2007; 13: 179-184
Article info
Publication history
Published online: January 09, 2014
Accepted:
January 1,
2014
Received:
October 31,
2013
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.