[Ischemic stroke and cardiac myxomas. Findings in cranial magnetic resonance imaging].

BACKGROUND

We report three patients with ischemic stroke as initial manifestation of left atrial myxomas.

UNASSIGNED

Case 1: man with difficulty in speaking for 15 minutes at the age of 33 years and dysarthria, right hemiparesis and hemisensory loss at the age of 36. Case 2: woman aged 29 with facial weakness and left limbs weakness for an hour. Case 3: woman with transient vertigo and paresthesia in right hemiface and upper limb for a month at the age of 35 years and difficulty for speaking, weakness of right limbs and loss of vision in left eye at the age of 40 years. The three patients had an atrial myxoma diagnosed by transthoracic or transesophageal echocardiography.

CONCLUSIONS

The three patients had ischemic stroke at a young age. The initial manifestation of the myxoma was a transient ischemic attack in two of them. Diagnosis was delayed more than 3 years in two of the patients. The second episode of the third patient affected all the left internal carotid territory including the posterior cerebral artery arising from the internal carotid and branches of the central retinal artery. Comparing the magnetic resonance with the previous one, new hyperintense images on T2 with gadolinium enhancement were found in the left hemisphere consistent with subacute infarcts that had stabilized 5 months later.