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目的:讨论左房黏液瘤所致脑栓塞、颅内动脉瘤的临床特点。方法:报告1例并发脑栓塞、多发颅内动脉瘤有罕见影像学表现的左房黏液瘤患者,结合相关文献进行复习分析。结果:左房黏液瘤患者的神经系统并发症由栓塞所致,反复脑栓塞导致严重神经功能损害,溶栓疗效与栓子的性质有关。肿瘤栓子可导致少见的迟发性颅内多发动脉瘤,动脉瘤慢性反复出血后出现罕见影像学表现,CT表现为脑内多发高密度病灶,MRI T1、T2及弥散加权均表现为极低信号病灶,周边伴镶边样高信号。结论:心房黏液瘤早期诊断、及时手术治疗,杜绝栓塞的发生至关重要,对黏液瘤术后进行随访有助于颅内动脉瘤的发现。
Objective: To discuss the clinical characteristics of left atrial myxoma-induced cerebral embolism and intracranial aneurysm. Methods: One case of left atrial myxoma complicated with cerebral embolism and multiple intracranial aneurysms who had rare imaging findings was reported, and the related literatures were reviewed. Results: The complications of nervous system in patients with left atrial myxoma were caused by embolism. Repeated cerebral embolism resulted in serious neurological damage. The thrombolytic therapy was related to the nature of emboli. Tumor emboli can cause rare delayed intracranial aneurysm, rare recurrence of aneurysm recurrence after radiographic manifestations, CT showed multiple high-density brain lesions, MRI T1, T2 and diffusion weighted showed very low Signal lesions, surrounded by edge-like high signal. Conclusion: The early diagnosis of atrial myxoma, timely surgical treatment, to prevent the occurrence of embolism is very important for follow-up of myxoma is helpful for the detection of intracranial aneurysms.