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Case Reports
Systematic Review and Case of Thrombectomy for Pediatric Stroke Due to Myxoma Embolism.
- Sruti Bandlamuri, Amanda Custozzo, Jonathan Silva, Sandeep Kiran Bandlamuri, Jiang Qian, and Alexandra R Paul.
- Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
- World Neurosurg. 2024 Mar 1; 183: e761e771e761-e771.
BackgroundStroke presentation secondary to a cardiac myxoma thromboembolism is rare in the pediatric population. Because of such rarity, the reported cases in the literature are primarily case reports. Additionally, general pediatric stroke management lacks evidence-based guidelines because of its low incidence and lack of clinical trials. In pediatric strokes identified from a cardiac myxoma, the incidence favors boys with the classical presentation of unilateral weakness and aphasia. We present a pediatric patient who presented with strokelike symptoms secondary to an intracranial embolus from a previously undiagnosed cardiac myxoma.MethodsWe performed a systematic review by searching PubMed, Google Scholar, Web of Science, and Embase databases for cases of pediatric myxoma causing stroke (n = 2431) and identified 19 reported uses of surgical management in treating pediatric patients who present with stroke symptoms secondary to a cardiac myxoma thromboembolism.ResultsThe most common imaging modality was magnetic resonance imaging in 42% of cases, computed tomography in 36.8%, followed by computed tomography angiography in 31.6% of cases. Of these 19 children treated with procedures, 36.8% of pediatric patients aged between 4 and 14 years underwent neurosurgery (n = 7).ConclusionsWe describe an urgent mechanical thrombectomy and share preoperative and postoperative images and pathology slides confirming a stroke from myxoma origin. We provide added insight in the safe use of mechanical thrombectomy as treatment for pediatric strokes secondary to a thromboembolism.Copyright © 2024 Elsevier Inc. All rights reserved.
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