Intravenous thrombolysis for pure pontine infarcts caused by cardiac myxoma: a case report and literature review.

Abstract

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.

• Authors: Mingming Dong, Yusong Ge, Jinwei Li, Kailei Fu, Liyang Zhang, Weiyu Teng, Li Tian
• Journal: The International journal of neuroscience (Int J Neurosci) Vol. 130 Issue 6 Pg. 635-641 (Jun 2020) ISSN: 1563-5279 [Electronic] England
• PMID: 31818173 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Fibrinolytic Agents
• Urokinase-Type Plasminogen Activator

Topics

• Administration, Intravenous
• Brain Stem Infarctions (drug therapy, etiology)
• Female
• Fibrinolytic Agents (therapeutic use)
• Heart Neoplasms (complications)
• Humans
• Middle Aged
• Myxoma (complications)
• Pons (blood supply, pathology)
• Stroke (drug therapy, etiology)
• Thrombolytic Therapy
• Treatment Outcome
• Urokinase-Type Plasminogen Activator (therapeutic use)