Document Detail


Safe and effective intravenous thrombolysis for acute ischemic stroke caused by left atrial myxoma.
MedLine Citation:
PMID:  19717026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atrial myxoma may be associated with syncope or sudden death attributed to left-sided cardiac outflow obstruction or embolization caused by tumor dislodgement or thrombus formation. Definitive treatment for primary and secondary stroke prevention is surgical resection. The role of thrombolysis in acute brain ischemia in patients with atrial myxoma is not defined. There are few data available regarding safety and efficacy of thrombolytic therapy in acute ischemic strokes caused by atrial myxoma. Prior case reports described partial success using intra-arterial local thrombolysis; however, this is invasive and can be associated with significant complications. A previously reported case of systemic thrombolysis resulted in development of cerebral hemorrhage. We describe a young man who presented with syncope and a dense stroke developing as a complication of atrial myxoma, followed by a remarkable recovery after treatment with intravenous recombinant tissue plasminogen activator and urgent cardiac surgery. Contrary to some expert opinion, systemic thrombolytic therapy may be safely and effectively used to treat acute ischemic strokes from atrial myxoma.
Authors:
Christian D Nagy; Michael Levy; Thomas J Mulhearn; Maryam Shapland; Henry Sun; David D Yuh; Dickson Cheung; Nisha Chandra-Strobos
Related Documents :
2627456 - In vitro thrombolysis of thrombosed valve prostheses: therapeutic considerations of lef...
11515916 - Delayed presentation of right ventricular bullet embolus.
3571756 - Comprehensive noninvasive evaluation of left atrial myxomas using cardiac cine-computed...
1952276 - Selective coronary angiography versus two-dimensional echocardiography for diagnosis of...
21510716 - Is the 'athlete's heart' arrhythmogenic?: implications for sudden cardiac death.
1872266 - Effects of diltiazem on long-term outcome after acute myocardial infarction in patients...
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  18     ISSN:  1532-8511     ISO Abbreviation:  J Stroke Cerebrovasc Dis     Publication Date:    2009 Sep-Oct
Date Detail:
Created Date:  2009-08-31     Completed Date:  2009-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  398-402     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease / therapy
Adult
Brain / blood supply,  pathology,  physiopathology
Brain Ischemia / drug therapy*,  etiology,  pathology
Cardiac Surgical Procedures
Cerebral Arteries / drug effects,  pathology,  physiopathology
Echocardiography, Transesophageal
Heart Atria / pathology,  surgery,  ultrasonography
Heart Neoplasms / complications*,  pathology,  surgery
Humans
Injections, Intravenous
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Male
Myxoma / complications*,  pathology,  surgery
Stroke / drug therapy*,  etiology,  pathology
Thrombolytic Therapy / methods*
Tissue Plasminogen Activator / administration & dosage
Treatment Outcome
Chemical
Reg. No./Substance:
EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Lies, damned lies, and statistics: a neurosurgical perspective on the international randomized trial...
Next Document:  Tortuous carotid artery lumens in Takayasu's arteritis.