Intravenous thrombolysis led to symptom improvement in 81.8% of patients with cardiac myxoma-related acute cerebral embolism, with a 22.7% rate of intracerebral hemorrhage and no IVT-related deaths.
Case Report (n=22)
Does intravenous thrombolysis improve symptoms safely in patients with cardiac myxoma-related acute cerebral embolism?
Intravenous thrombolysis appears to be an effective and relatively safe ultra-early treatment for cardiac myxoma-related acute ischemic stroke, despite a 22.7% rate of intracerebral hemorrhage.
Purpose: Cardiac myxoma (CM) is a rare but important cause of ischemic stroke, and typically involves the middle cerebral artery and rarely affects the brainstem only. The safety and efficacy of intravenous thrombolysis (IVT) for CM-related acute cerebral embolism are not clear.Methods: We report a case of a 55-year-old woman who suffered a CM-related acute cerebral embolism presented with pure pontine infarcts and achieved a favorable prognosis by IVT with urokinase. We summarized the clinical data of this entity and performed a literature review of 21 previous reports of patients with CM-related acute cerebral embolism who were treated with IVT.Results: In combination with previous reports, we found that the majority of patients (81.8%) obtained improvements in symptoms after IVT, including 63.6% in remarkable clinical improvement. The total rate of IVT-induced intracerebral hemorrhage was 22.7% and all occurred within 36 h, including hemorrhagic infarction type 1 (4.5%) and parenchymal hematoma type 2 (18.2%). Most of the cases had relatively good outcomes and no case died due to IVT.Conclusion: Taken together, our findings support the use of IVT as an effective and safe tool for the ultra-early treatment of CM-related acute phase ischemic stroke.
Dong et al. (Tue,) conducted a case report in Cardiac myxoma-related acute cerebral embolism (n=22). Intravenous thrombolysis was evaluated on Improvement in symptoms. Intravenous thrombolysis led to symptom improvement in 81.8% of patients with cardiac myxoma-related acute cerebral embolism, with a 22.7% rate of intracerebral hemorrhage and no IVT-related deaths.