Long Youming, Gao Cong
Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of GuangZhou Medical University, 250 Changgang East Road, Guangzhou, Guangdong 510260, China ; Department of Neurology, The Second Affiliated Hospital of GuangZhou Medical University, 250 Changgang East Road, Guangzhou, Guangdong 510260, China.
ScientificWorldJournal. 2014 Mar 9;2014:718246. doi: 10.1155/2014/718246. eCollection 2014.
Heart myxoma-related embolisms commonly involve the central nervous system, but data are lacking in Chinese patients.
27 patients diagnosed with myxoma were reviewed retrospectively.
Among 27 patients, fourteen (51.9%) patients were women. Fifteen (55.6%) patients had brain embolisms. Rarely, patients were misdiagnosed with central nervous system vasculitis (n = 2), moyamoya disease (n = 1), and neuromyelitis optica (n = 1). We found positive associations between mRS (>3) and female gender (r = 0.873, P < 0.0001), infection (r = 0.722, P = 0.002), severe complications (r = 0.722, P = 0.002), systolic blood pressure (SBP) of <120 mmHg (r = 0.6, P = 0.018), WBC count of >10 × 10(9)/L (r = 0.722, P = 0.002), tumour size (r = 0.866, P < 0.0001), bilateral brain lesions (r = 0.60, P = 0.018), and total anterior circulation infarction (TACI) (r = 0.667, P = 0.007). The independent relationships among these factors and outcomes could not be confirmed (P > 0.05).
Neurologic manifestations in Chinese patients with cardiac myxoma-related stroke were complicated and multifarious. Female gender, infection, other severe complications, low SBP, tumour size, bilateral brain lesions, TACI, and high WBC counts could be associated with a poor prognosis.
心脏黏液瘤相关栓塞通常累及中枢神经系统,但中国患者的数据尚缺乏。
对27例诊断为黏液瘤的患者进行回顾性分析。
27例患者中,14例(51.9%)为女性。15例(55.6%)患者发生脑栓塞。少数患者被误诊为中枢神经系统血管炎(n = 2)、烟雾病(n = 1)和视神经脊髓炎(n = 1)。我们发现改良Rankin量表评分(mRS)>3与女性性别(r = 0.873,P < 0.0001)、感染(r = 0.722,P = 0.002)、严重并发症(r = 0.722,P = 0.002)、收缩压(SBP)<120 mmHg(r = 0.6,P = 0.018)、白细胞计数>10×10⁹/L(r = 0.722,P = 0.002)、肿瘤大小(r = 0.866,P < 0.0001)、双侧脑病变(r = 0.60,P = 0.018)和完全前循环梗死(TACI)(r = 0.667,P = 0.007)之间存在正相关。这些因素与预后之间的独立关系无法得到证实(P > 0.05)。
中国心脏黏液瘤相关卒中患者的神经学表现复杂多样。女性性别、感染、其他严重并发症、低SBP、肿瘤大小、双侧脑病变、TACI和高白细胞计数可能与预后不良有关。