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Stroke, Vol 24, 1090-1092, Copyright © 1993 by American Heart Association

ARTICLES

Fulminant brain necrosis from atrial myxoma showers

WT Browne, EF Wijdicks, JE Parisi and RW Viggiano
Department of Neurology, Mayo Clinic, Rochester, MN 55905.

BACKGROUND: Atrial myxoma is uncommon and may be associated with brief isolated ischemic events. We describe a patient with atrial myxoma and an incompletely evaluated ischemic stroke followed 1 year later with almost complete brain necrosis. SUMMARY OF REPORT: A 63-year-old woman presented with a rapidly progressive illness resulting in coma within 24 hours from multiple myxomatous emboli. Cranial computed tomographic scan demonstrated multiple hypodensities in both cerebellar and cerebral hemispheres. Postmortem examination revealed virtually complete brain necrosis, multiple peripheral artery embolizations, embolization in the coronary arteries with acute myocardial infarction, and tumor emboli in the spleen and kidneys. CONCLUSIONS: Although uncommon, atrial myxoma may present as a fatal multiple organ embolization that includes both anterior and posterior circulation territories of the brain.

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