A Case of Cerebral Oncotic Aneurysms and Intracerebral Hemorrhage Caused by Left Atrial Myxoma

(Department of Cardiovascular Surgery, Chugoku Rosai Hospital, Kure, Japan)

Tomokuni Furukawa Saihou Hayashi Masafumi Sueshiro
We encountered a case of cerebral oncotic aneurysms and intracerebral hemorrhage after resection of a left atrial myxoma. A 67-year-old woman underwent resection of the left atrial myxoma. She was followed by ultrasound cardiography on an ambulatory basis. About one and a half years later, she was hospitalized because of neural symptoms. Multiple cerebral aneurysms and intracerebral hematoma were found, and the hematoma was removed. With the neural symptoms recurring repeatedly thereafter, however, she eventually died due to pneumonia. The pathological examination of the intracerebral hematoma removed at operation and cerebral aneurysms at autopsy revealed myxoma cells causing embolisms in the artery and invading the atrial wall with some hemorrhage. It is known that cardiac myxoma occasionally causes a cerebral lesion. The lesion is presumed to be caused by embolism as in our case. So it is nessesary to evaluate morphologic characteristics of cardiac myxoma before operation and to pay attention to the occurrence of embolism during operation. Making a rigorous follow-up of the general progress by computed tomography after operation is also considered important.
@Jpn. J. Cardiovasc. Surg. 34: 342-346 (2005)