CNS embolism due to atrial myxoma: clinical features and diagnosis
B. A. Sandok, I. von Estorff and E. R. Giuliani
The records of 40 patients with pathologically verified atrial myxoma
identified during the period 1957 to 1977 were studied. The patients ranged
in age from 17 to 77 years; women predominated by a ratio of 3:1.
Thirty-five patients had left atrial myxoma, three patients had right
atrial myxoma, one patient had bilateral myxomas, and one patient had a
right atrial myxoma and subsequent removal of a left atrial myxoma. Ten of
the 37 patients (27%) with left atrial myxoma had at least one neurologic
event suggesting ischemia secondary to embolization. Transient or permanent
ischemic events were noted in the cerebral hemispheres, brainstem,
cerebellum, retina, and spinal cord. Although some patients were seen at
the initial evaluation with primarily neurologic events, cardiac and
constitutional symptoms dominated the clinical picture. Echocardiography
and sector scanning provide a practical method for early clinical
diagnosis.
