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Neurology International
Volume 2
Issue 1
10.4081/ni.2010.e5
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Neurology International is published by MDPI from Volume 12 Issue 3 (2020). Previous articles were published by another publisher in Open Access under a CC-BY licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Case Report

Microemboli Monitoring by Trans-Cranial Doppler in Patient with Acute Cardioemboliogenic Stroke due to Atrial Myxoma

by
Gregory Telman
1,*,
Orit Mesica
1,
Efim Kouperberg
1,
Oved Cohen
2,
Gil Bolotin
2 and
Yoram Agmon
3
1
Departments of Neurology, Rambam Health Care Campus, Haifa, Israel
2
Departments of Cardiac Surgery, Rambam Health Care Campus and Technion Faculty of Medicine, Haifa, Israel
3
Departments of Cardiology, Rambam Health Care Campus and Technion Faculty of Medicine, Haifa, Israel
*
Author to whom correspondence should be addressed.
Neurol. Int. 2010, 2(1), e5; https://doi.org/10.4081/ni.2010.e5
Submission received: 8 June 2009 / Revised: 9 December 2009 / Accepted: 20 January 2010 / Published: 11 March 2010

Abstract

This is the first reported attempt to examine the emboliogenic potential of cardiac myxoma in patients with acute stroke through the monitoring of microembolic signals (MES) by transcranial doppler. A 43-year old woman was brought to the emergency department because of acute onset of generalized tonic-clonic seizures and left hemiplegia. A CT scan of the brain demonstrated a large acute infraction in the territory of the right middle cerebral artery (MCA) and another smaller one in the territory of the posterior cerebral artery on the same side. Trans-cranial doppler (TCD) microemboli monitoring did not reveal MES. Transesophagial echocardiography (TEE) identified a 5 cm left atrial mass, which was highly suspected to be an atrial myxoma attached to the interatrial septum and prolapsed through the mitral valve. After the TEE results were obtained, another TCD monitoring was performed. Again, there were no MES found in either of the MCAs. Our findings showed the absence of MES on two consecutive TCD examinations, suggesting a spontaneous occurrence, rather than the permanent presence, of embolization, even in the most acute phase of stroke. Thus, the tendency of myxomas to spontaneously produce multiple emboli emphasizes the need for the surgical excision of myxomas.
Keywords: myxoma; stroke; transcranial doppler myxoma; stroke; transcranial doppler

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MDPI and ACS Style

Telman, G.; Mesica, O.; Kouperberg, E.; Cohen, O.; Bolotin, G.; Agmon, Y. Microemboli Monitoring by Trans-Cranial Doppler in Patient with Acute Cardioemboliogenic Stroke due to Atrial Myxoma. Neurol. Int. 2010, 2, e5. https://doi.org/10.4081/ni.2010.e5

AMA Style

Telman G, Mesica O, Kouperberg E, Cohen O, Bolotin G, Agmon Y. Microemboli Monitoring by Trans-Cranial Doppler in Patient with Acute Cardioemboliogenic Stroke due to Atrial Myxoma. Neurology International. 2010; 2(1):e5. https://doi.org/10.4081/ni.2010.e5

Chicago/Turabian Style

Telman, Gregory, Orit Mesica, Efim Kouperberg, Oved Cohen, Gil Bolotin, and Yoram Agmon. 2010. "Microemboli Monitoring by Trans-Cranial Doppler in Patient with Acute Cardioemboliogenic Stroke due to Atrial Myxoma" Neurology International 2, no. 1: e5. https://doi.org/10.4081/ni.2010.e5

APA Style

Telman, G., Mesica, O., Kouperberg, E., Cohen, O., Bolotin, G., & Agmon, Y. (2010). Microemboli Monitoring by Trans-Cranial Doppler in Patient with Acute Cardioemboliogenic Stroke due to Atrial Myxoma. Neurology International, 2(1), e5. https://doi.org/10.4081/ni.2010.e5

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