Liou C W, Chang C S, Chen H J, Lui C C, Chen L
Department of Neurology, Chang Gung Memorial Hospital, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1990 Sep;13(3):231-6.
Although embolism is known as a common complication in the early growing stage of atrial myxoma, development of further neurologic disorders after the removal of tumor is rarely encountered. Arterial aneurysm formation and metastatic tumor growth represent the two disorders that had been reported in the literature. Based on the pathogenesis of hematogeneous disseminating, atrial myxoma may lodge its fragment or its adherent thrombus on intracranial vessels to produce cerebral infarct. Besides, several reports have indicated that myxoma emboli in the cerebral vessels may invade the vessel wall to produce delayed disorders. Embolization from atrial myxoma is now recognized as a potentially treatable cause of cerebral infarct. However, the long-term course following resection of the tumor remain complicated, partly due to these inconsistent delayed complications, or the therapeutic dilemma. We report a case with delayed intracranial aneurysm formation and reviewed the literature. A 67-year old woman with a past history of left cerebral infarction was transferred to our hospital for further evaluation of her gross hematuria. Infarction of the left kidney was then demonstrated by angiography. A left atrial myxoma was found in a echocardiographic screen, and the patient received a successful resection of the myxoma subsequently. Unfortunately, three episodes of stroke developed in a half year after the operation of the cardiac myxoma.(ABSTRACT TRUNCATED AT 250 WORDS)
尽管栓塞是心房黏液瘤早期生长阶段的常见并发症，但肿瘤切除后进一步出现神经系统疾病的情况却很少见。文献报道的两种疾病是动脉动脉瘤形成和转移性肿瘤生长。基于血行播散的发病机制，心房黏液瘤可能会将其碎片或附着的血栓滞留在颅内血管上，从而导致脑梗死。此外，一些报告表明，脑血管中的黏液瘤栓子可能会侵入血管壁，导致延迟性疾病。现在，心房黏液瘤栓塞被认为是脑梗死的一个潜在可治疗原因。然而，肿瘤切除后的长期病程仍然复杂，部分原因是这些不一致的延迟并发症或治疗困境。我们报告了一例延迟性颅内动脉瘤形成的病例并复习了文献。一名有左脑梗死病史的67岁女性因肉眼血尿被转诊至我院进一步评估。血管造影显示左肾梗死。超声心动图检查发现左心房黏液瘤，患者随后成功切除了黏液瘤。不幸的是，心脏黏液瘤手术后半年内发生了三次中风。（摘要截选至250字）
