• BMJ case reports · Jan 2013

    Case Reports

    A large left atrial myxoma causing multiple cerebral infarcts.

    • Saba Kebede, Eiry Edmunds, and Adrian Raybould.
    • Department of Medicine, Hywel Dda Health Board, Carmarthen, UK.
    • BMJ Case Rep. 2013 Jan 1;2013.

    AbstractA 52-year-old man presented with a history of sudden onset diplopia. On neurological examination, the only abnormality was a right-sided oculomotor (third nerve) palsy. A brain CT was performed and reported as showing no abnormality. He was discharged to be investigated as an outpatient. He presented 1 month later with a new expressive dysphasia and confusional state. MRI was performed which revealed multiple cerebral infarcts. He was discharged on secondary stroke prevention medication. Six months elapsed, before a transthoracic echocardiogram was performed. This showed a large left atrial myxoma. The patient underwent an emergency resection and made a good postoperative recovery. This case report showed the importance of considering a cardiogenic source of emboli in patients who present with cerebral infarcts. Performing echocardiography early will help to detect treatable conditions such as atrial myxoma, and prevent further complications.

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