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The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo
Published on: December 19, 2025
Effective intravenous thrombolytic therapy in a patient with cerebral infarction associated with left atrial myxoma
Mayumi Abe1, Ai Kohama, Takahiro Takeda
1Department of Neurology, Tokyo Women's Medical University, Yachiyo Medical Center, Japan. abe_tymc@yahoo.co.jp
Abstract:
A 70-year-old man presented with sudden onset of global aphasia and right hemiplegia. Brain MRI revealed occlusion of the left middle cerebral artery. He was diagnosed as having a hyperacute cerebral infarction. Intravenous thrombolytic therapy was started, and the neurological symptoms were resolved after 11 h. Echocardiography showed a mobile mass in the left atrium, suspicious of a myxoma. The tumor was resected and pathologically diagnosed as a myxoma. In this patient, intravenous thrombolytic therapy was effective, and no adverse effects were observed. This suggests that, even with complications of myxoma, thrombolytic therapy can be considered if there are no contraindications.
Insights
A 70-year-old man with a left middle cerebral artery occlusion experienced stroke symptom resolution after intravenous thrombolytic therapy. Echocardiography revealed a cardiac myxoma, suggesting thrombolysis can be safe even with this complication.
Area of Science:
- Neurology
- Cardiology
- Oncology
Background:
- Cerebral infarction presents with acute neurological deficits.
- Cardiac myxomas can be a source of embolic stroke.
- Thrombolytic therapy is a critical treatment for acute ischemic stroke.
Observation:
- A 70-year-old male presented with global aphasia and right hemiplegia, indicative of a stroke.
- Brain MRI confirmed left middle cerebral artery occlusion, diagnosing a hyperacute cerebral infarction.
- Echocardiography identified a mobile left atrial mass, suspected to be a myxoma.
Findings:
- Intravenous thrombolytic therapy led to complete resolution of neurological symptoms within 11 hours.
- Surgical resection confirmed the left atrial mass as a myxoma.
- The patient experienced no adverse effects from thrombolytic therapy despite the cardiac myxoma.
Implications:
- Intravenous thrombolytic therapy can be a safe and effective treatment for acute ischemic stroke in patients with cardiac myxoma.
- This case highlights the importance of cardiac evaluation in stroke patients to identify potential embolic sources.
- Thrombolysis should be considered in stroke patients with myxoma, provided no contraindications exist.
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