Cardioembolic stroke secondary to a cardiac myxoma

We present the case of a young male who developed a cardioembolic stroke secondary to a cardiac myxoma, a rare but important cause of ischemic stroke, especially in patients without traditional stroke risk factors. The patient, a 32-year-old male, initially presented with altered consciousness and unilateral hemiplegia, with early neuroimaging showing no significant findings; however, follow-up imaging revealed bilateral, multi-territorial ischemic infarctions. Diagnosis was confirmed through echocardiography, cardiac magnetic resonance imaging (CMR) and histopathology, and the patient later experienced central retinal artery occlusion (CRAO) and radial artery occlusion. Surgical resection was performed at 21 days from presentation without significant complications. This case emphasizes the importance of considering cardiac myxoma in the differential diagnosis of ischemic stroke in young patients, the need for thorough diagnostic workup when initial imaging is negative and the challenge of timing surgery, which should be done in a multidisciplinary setting to balance the risks of neurological complications with the benefits of early intervention.