Multiple cerebral aneurysms as a late complication of atrial myxoma – imaging findings

Congress:

2023 ASM

Poster Number:

C-23

Type:

Educational Exhibit

Keywords:

CNS, Catheter arteriography, CT-Angiography, MR-Angiography, Education, Aneurysms

Authors:

A. Ajjikuttira, A. Coulthard

DOI:

10.26044/ranzcr2023/C-23

DOI-Link:

https://dx.doi.org/10.26044/ranzcr2023/C-23

Background

Myxomas are a benign cardiac tumour, with over 75% arising in the left atrium.¹ They may manifest in multiple ways, including obstructive symptoms, thromboembolic events and constitutional symptoms.¹ Thromboembolic manifestations depend on the location of the atrial myxoma. Right-sided atrial myxoma may result in pulmonary emboli. Left-sided atrial myxoma may result in the development of fusiform cerebral aneurysms.²

Two theories describe the pathogenesis of aneurysm formation related to myxoma embolism. In one, aneurysm formation occurs due to embolic myxoma cells penetrating into the arterial wall², supported by histological studies.³ In the other, cerebral vessels become temporarily occluded by myxoma cells, damaging the endothelium and promoting aneurysm formation.⁴

Fig 1: Figure 1 - Normal cerebral digital subtraction angiogram. (a) Right coronal,...

Fig 2: Figure 2 - CT cerebral angiogram revealing interval development of multiple...

Fig 3: Figure 3 - Cerebral digital subtraction angiogram confirming interval...