Child Neurology: Arterial ischemic stroke in a 12-year-old patient with cardiac myxomas

Abstract

Arterial ischemic strokes (AIS) are the most frequent neurologic sequela encountered in patients with cardiac myxomas. Although most of these AIS are thrombotic in nature, occasionally embolized tumor fragments may be responsible for the ischemic damage.1 Most patients with cardiac myxoma are women between the third and the sixth decade of life, who present with one or more symptoms of the classic triad (hemodynamic instability due to intracardiac obstruction, systemic embolization, and constitutional symptoms).1 Carney complex is an inherited disorder characterized by myxomas that often present earlier in life. We present a 12-year-old girl who developed a pediatric AIS (PAIS) due to the direct embolization of cardiac myxomatous tissue fragments in the setting of Carney complex. We discuss the clinical presentation, case-specific differential diagnosis, and workup, followed by epidemiology, pathophysiology, treatment, and prognosis of AIS resulting from cardiac myxomas.