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Neurological Complications of Cardiac Tumors

  • Neurology of Systemic Diseases (J. Biller, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This article reviews recent literature regarding the neurological manifestations of cardiac tumors, including diagnosis, pathophysiology, and treatment.

Recent Findings

Clinical cases of patients with acute ischemic stroke due to cardiac tumors who were treated with intravenous alteplase show a favorable safety profile. Mechanical thrombectomy seems to be a reasonable treatment alternative for these patients, when there is a large vessel occlusion. Histopathology analysis of mechanical thrombectomy specimens may allow the diagnosis of a cardiac tumor. Prolonged time interval between stroke and tumor excision surgery is significantly associated with stroke recurrence. Myxomatous aneurysms are a late complication of cardiac myxomas, which commonly demand imaging follow-up after excision of the primary tumor. Aneurysms are more frequent in patients who present with other embolic complications. Conservative treatment of myxomatous aneurysms is a reasonable strategy, as the majority of aneurysms remain stable over many years. Spontaneous regression of these formations has been documented after excision of the primary tumor. Other complications recently described include acute psychosis and mononeuropathy multiplex.

Summary

Cardiac tumors are rare. There are mainly case reports and retrospective case series describing the neurological manifestations of cardiac tumors. Hyperacute stroke treatment seems to be safe, and mechanical thrombectomy is a reasonable treatment. A conservative approach towards myxomatous aneurysms should be considered.

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Authors and Affiliations

  1. Department of Neurosciences and Mental Health, Neurology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal

    Madalena Rosário, Ana Catarina Fonseca, Filipa Dourado Sotero & José M. Ferro

  2. Faculdade de Medicina, Hospital de Santa Maria, Universidade de Lisboa, Neurology 6th floor, Avenida Professor Egas Moniz s/n, 1649-035, Lisbon, Portugal

    Ana Catarina Fonseca & José M. Ferro

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  1. Madalena Rosário
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Correspondence to José M. Ferro.

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Conflict of Interest

Jose Ferro reports grants from Bayer, personal fees from Boehringer Ingelheim, outside the submitted work. Madalena Rosário, Filipa Dourado Sotero and Ana Catarina Fonseca each declare no potential conflicts of interest.

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Rosário, M., Fonseca, A.C., Sotero, F.D. et al. Neurological Complications of Cardiac Tumors. Curr Neurol Neurosci Rep 19, 15 (2019). https://doi.org/10.1007/s11910-019-0931-1

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