Division of Cerebrovascular Diseases, Department of Neurology, Carver College of Medicine, University of Iowa Hospitals and Clinics, University of Iowa, Iowa City, IA, United States.
Handb Clin Neurol. 2021;177:275-282. doi: 10.1016/B978-0-12-819814-8.00016-0.
Primary tumors of the heart, most commonly myxoma, are an uncommon cause of ischemic stroke and intracranial aneurysms. The tumors may occur in any age group but are most frequently detected in middle-aged persons with an atypical or cryptogenic stroke. While some patients will have a history of cardiac or constitutional symptoms, in many cases ischemic stroke will be the initial manifestation of the cardiac mass. Myxomas are the most common cardiac tumors, and valvular fibroelastoma is also a potential cardiac cause of stroke. Among patients with stroke, the most common location for a myxoma is the left atrium. Elevations of inflammatory markers provide clue for a myxoma. Cardiac imaging is the most definitive diagnostic study. Treatment centers on surgical removal of the cardiac mass may be curative.
心脏原发性肿瘤,最常见的是黏液瘤,是引起缺血性脑卒中及颅内动脉瘤的不常见病因。肿瘤可发生于任何年龄段,但最常发生于中年人群,表现为非典型或隐匿性脑卒中。部分患者有心脏或全身症状病史,而在许多情况下,缺血性脑卒中是心脏肿块的首发表现。黏液瘤是最常见的心脏肿瘤,瓣膜状弹性纤维瘤也是引起脑卒中的潜在心脏病因。在脑卒中患者中,黏液瘤最常见的发生部位是左心房。炎症标志物升高为黏液瘤提供线索。心脏影像学检查是最明确的诊断性研究。治疗方法是手术切除心脏肿块,可能达到治愈效果。