[Recurrent cerebral embolism as the main sign of atrial myxoma]

Atrial myxomas (AM) are the most frequent cardiac tumors. Between 25-45% of the cases present neurologic manifestations, generally owing to cerebral embolic infarcts or intracranial haemorrhages. Cerebral embolism can precede cardiac or constitutional symptoms, but recurrent embolisms as the only disturbance are infrequent. We present the case of two patients with 66 and 70 years that suffered recurrent cerebral embolisms as the only manifestation of a left AM. Magnetic resonance (MR) studies showed several isquemic infarcts in different vascular territories. Echocardiagrams showed the presence of heterogeneous masses in left atrial that suggested AM. These were removed in both cases and the diagnosis of AM was confirmed by anatomopathologic exam. The presence of recurrent isquemic episodes in different cerebral territories must point the diagnosis to a cardioembolic source. AM must be taken into account in these cases, despite the lack of constitutional or cardiac symptoms, older age or concomitant carotid pathology.