O8-3 A case of acute ischemic stroke secondary to myxoma treated by IV t-PA therapy

We present a patient treated with IV t-PA who developed brain embolism caused by left atrial myxoma. A 31-year-old woman was admitted to our hospital 55 minutes after the onset of aphasia and right hemiparesis. Neurological symptoms on admission were aphasia and right hemiparesis (NIHSS 12). Diffusion weighted magnetic resonance imaging showed high intensity in the left middle cerebral artery territory. Magnetic resonance angiography demonstrated complete left middle cerebral artery occlusion. She was diagnosed cardioembolic infarction and IV t-PA was started 55minutes after onset. Two hours later, her neurological defects were improved (NIHSS 1). Two days later, echocardiography revealed a left atrial myxoma. Three days later open heart surgery was performed to remove the tumor. The histological diagnosis was cardiac myxoma.