A Surgical Case of Left Atrial Myxoma Complicated with Massive Hemorrhagic Cerebral Infarction
- VernacularTitle:正中偏位を伴う広範な出血性脳梗塞を合併した左房粘液腫に対する1手術例
- Author:
Hisaya MORI
1
;
Hisato TAKAGI
1
;
Yosuke HARI
1
;
Noritsugu NAITO
1
Author Information
- Keywords: left atrial myxoma; hemorrhagic cerebral infarction; midline shift
- From:Japanese Journal of Cardiovascular Surgery 2024;53(5):259-262
- CountryJapan
- Language:Japanese
- Abstract: A 63-year-old female suddenly suffered right hemiplegia. Multiple cerebral infarctions in the nucleus basalis and the frontal and temporal lobes perfused by the left middle cerebral artery were diagnosed. A left atrial myxoma probably causing the cerebral infarctions was identified. The patient underwent anticoagulation therapy with heparin to prevent recurrent cerebral infarctions while waiting for surgical resection of the myxoma. Motor aphasia, however, occurred on the 8th day after the onset of the cerebral infarctions. Extensive hemorrhagic cerebral infarctions involving the left temporal and frontal lobes with a midline shift occurred, and accordingly the anticoagulation therapy was discontinued. After a 6-week interval from the hemorrhagic cerebral infarctions, the left atrial myxoma was successfully resected, and the patient was discharged from the hospital without any new neurological complications. Even if left atrial myxoma complicates extensive hemorrhagic cerebral infarctions, surgical resection may be safely performed allowing a sufficient interval. Anticoagulation therapy to prevent recurrent cerebral infarctions while waiting for surgery after cerebral infarctions should be avoided because of the risk of hemorrhagic cerebral infarctions, and early surgery should be considered.
