부산대학교 도서관

Cardiac myxoma, one of the causes of cerebral infarction in young patients, is complicated by a systemic embolism in 30％‒40％ of the cases. Cerebral embolism is the most common systemic embolism associated with cardias myoma, but it is rare. We describe a cerebral embolism caused by a giant left arterial myxoma, which was resected to prevent sudden death within the day of cerebral infarction. A 48‒year‒old Japanese man was transferred to our hospital for dysarthria and sensory disturbance in his upper limb when he woke up. His medical history and blood tests were unremarkable. He had no atrial fibrillation. Although head MRI revealed a cerebral infarction in his bilateral cerebellum and right occipital lobe, intravenous tissue plasminogen activator (t‒PA) or mechanical thrombectomy was not indicated. Transthoracic echocardiography revealed a 51‒mm × 40‒mm mobile giant myxoma attached to the atrial septum. Because his myxoma was considered at high risk of inducing cardiac sudden death, the patient was transferred by helicopter to a hospital in which cardiac surgery was available. His myxoma was resected by open‒heart surgery, and he was discharged home on day 30 with the modified Rankin Scale value of 1. The causes of cerebral embolism in young individuals are distinct from those in the elderly, and they can include fatal entities. This patient’s case emphasizes the need to perform immediate echocardiography for a cerebral embolism to rule out rare fatal entities, especially in young patients without atrial fibrillation.