Al-Mateen Majeed, Hood Margaret, Trippel Don, Insalaco Samuel J, Otto Randolph K, Vitikainen Kari J
Pediatric Neurology Clinic, Mary Bridge Children's Hospital and Health Center, Tacoma, Washington 98415, USA.
Pediatrics. 2003 Aug;112(2):e162-7. doi: 10.1542/peds.112.2.e162.
We describe 2 children with cerebrovascular events caused by emboli from left atrial myxomas and review 7 other pediatric cases from the literature. Transient cutaneous eruptions involving the extremities preceded the cerebrovascular events and were most likely attributable to fragmentation of the atrial tumor with peripheral embolization. Our first case demonstrates the more common presentation with acute hemiplegia caused by cerebral infarction and the second case a transient ischemic attack manifested by more subtle features as a result of involvement of the vertebrobasilar circulation. Neither child had a history or other signs of cardiac disease. Atrial myxoma should be considered in the differential diagnosis when children present with neurologic symptoms or with signs of embolization, because surgical removal of the tumor is critical and may be curative.
我们描述了2例因左心房黏液瘤栓子导致脑血管事件的儿童，并回顾了文献中另外7例儿科病例。在脑血管事件之前出现了累及四肢的短暂性皮肤疹，这很可能归因于心房肿瘤破碎伴外周栓塞。我们的第一例病例展示了由脑梗死引起的急性偏瘫这种更常见的表现，第二例病例则是由于椎基底循环受累而表现为更隐匿特征的短暂性脑缺血发作。两个孩子均无心脏病史或其他体征。当儿童出现神经系统症状或栓塞体征时，鉴别诊断应考虑心房黏液瘤，因为手术切除肿瘤至关重要且可能治愈。
