2021 Volume 43 Issue 3 Pages 262-266
An 89-year-old woman was transferred to our hospital with a sudden onset of consciousness disturbance. Brain MRI showed basilar artery occlusion. Intravenous tissue plasminogen activator was started, but she did not improve neurologically and thus endovascular treatment was performed. The embolus in the basilar artery was successfully retrieved by using a combined technique with a stent retriever and an aspiration catheter at 172 minutes after the onset. The retrieved embolus was whitish in color and suggested pathologically myxoma. Initially, the cardiac tumor was not detected by transthoracic echocardiography and MRI. One month later, transthoracic echocardiography detected a tumor in her left ventricle, and she underwent cardiac surgery on the same day. The cardiac tumor was identified as myoma. Although the embolus suggested myoma prior to echocardiography, it was not found at the same time. This case shows the importance of a repeat echocardiography for preventing from a recurrent embolism.
