PMC4634163_01
An 11-year-old boy left atrial myxoma with oncotic aneurysms; (A) FLAIR image of the brain shows acute infarct in the form of hyper-intensity in the left gangliocapsular region. (B) Diffusion weighted image shows restricted diffusion in the corresponding area.
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An acute infarct was noted on T2, FLAIR and DW images in the left gangliocapsular region (Figure 1A, 1B).
An 11-year-old boy with left atrial myxoma and oncotic aneurysms; MR Angiogram (Time of flight sequence) shows complete cut-off of M1 segment of the left middle cerebral artery (MCA) (red arrow) and an aneurysm in the intradural segment of the right vertebral artery (yellow arrow).
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Angiogram showed complete cut-off of segment M1 of the left middle cerebral artery (MCA) and an aneurysm in the intradural segment of the right vertebral artery (Figure 2). After one month, follow-up MRI with MRA showed gliotic area in the left gangliocapsular region and a partially recanalized, tortuous, narrowed left MCA (Figure 3A, 3B).
An 11-year-old boy with left atrial myxoma and oncotic aneurysms; Follow-up MR, (A) shows gliotic area in the left gangliocapsular region (red arrow). (B) MR Angiogram (Time of flight sequence) shows partially recanalized, tortuous, narrowed left MCA (yellow arrow).
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Angiogram showed complete cut-off of segment M1 of the left middle cerebral artery (MCA) and an aneurysm in the intradural segment of the right vertebral artery (Figure 2). After one month, follow-up MRI with MRA showed gliotic area in the left gangliocapsular region and a partially recanalized, tortuous, narrowed left MCA (Figure 3A, 3B).
An 11-year-old boy with left atrial myxoma and oncotic aneurysms; Digital subtraction angiography (DSA), Left ICA angiogram shows - (A) irregular, narrowed and tortuous left MCA (small white arrow). (B) An aneurysm in the distal branch of left MCA (large white arrow).
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On digital subtraction angiography (DSA), left MCA appeared irregular, narrowed, and tortuous, and multiple aneurysms were seen in distal branches of bilateral MCA (right>left) (Figures 4, 5) and in the intradural segment of the right vertebral artery (Figure 6A, 6B).
An 11-year-old boy with left atrial myxoma and oncotic aneurysms; Digital subtraction angiography (DSA), Right ICA angiogram (A-D) - show multiple aneurysms in distal branches of the right middle cerebral artery (white arrows).
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On digital subtraction angiography (DSA), left MCA appeared irregular, narrowed, and tortuous, and multiple aneurysms were seen in distal branches of bilateral MCA (right>left) (Figures 4, 5) and in the intradural segment of the right vertebral artery (Figure 6A, 6B).
An 11-year-old boy with left atrial myxoma and oncotic aneurysms; Digital subtraction angiography (DSA), Right vertebral angiogram (A, B) - show an aneurysm in the intradural segment of the right vertebral artery before its junction with the basilar artery (arrow).
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On digital subtraction angiography (DSA), left MCA appeared irregular, narrowed, and tortuous, and multiple aneurysms were seen in distal branches of bilateral MCA (right>left) (Figures 4, 5) and in the intradural segment of the right vertebral artery (Figure 6A, 6B).
An 11-year-old boy with left atrial myxoma and oncotic aneurysms; One year after non-contrast computed tomography shows - (A) - infracts (not visible one year before) in the head of the right caudate nucleus (small white arrow) and (B) - right high parietal region (small white arrow). In addition (B) - also show an old infarct in the left gangliocapsular area (large white arrow).
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Doppler echocardiography showed a left atrial myxoma, 5.2x5.1x2.1 cm in size, which originated from the inferior inter-atrial septum and prolapsed into the left ventricle (Figure 7A). The histopathological examination of the specimen revealed findings of myxoma in the form of spindle-shaped lipidic cells in a loose myxoid stroma (Figure 7B).
An 11-year-old boy with left atrial myxoma and oncotic aneurysms; One year after CT angiogram shows - (A) - tortuous, dilated and fusiform left MCA (large white arrow). (B) show multiple aneurysms in the distal branches of bilateral middle cerebral and vertebral arteries (small white arrows).
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Recent computed tomography showed infarcts (not visible one year before) in the head of the right caudate nucleus and the right high parietal region, and chronic infarct in the left gangliocapsular area (Figure 8A, 8B).