Top of the Basilar Syndrome with Painful Palmar Reticulated Erythematous Patches Complicating Cardiac Atrial Myxoma: A Case Report

Authors

  • Rojanant Huangsaithong Division of Neurology, Department of Medicine, Phramongkutklao Hospital
  • Chesda Udommongkol Division of Neurology, Department of Medicine, Phramongkutklao Hospital
  • Julphat Intarasupht Division of Dermatology, Department of Medicine, Phramongkutklao Hospital
  • Yotin Chinvarun Division of Neurology, Department of Medicine, Phramongkutklao Hospital

Keywords:

cardiac myxoma, embolism, stroke, erythematous patch

Abstract

The authors reported an uncommon ischemic stroke in a young patient with an unusual dermatologic manifestation. A 28-year-old Thai woman presented with acute vertigo, ataxia, vertical diplopia, and impaired vertical gazes. Multiple painful, ill defined-border, reticulated, erythematous, and non-blanchable patches were formerly presented in both palms one day before the stroke onset. MRI showed hypersignals in bilateral thalami and left paramedian midbrain region on DWI with corresponding ADC map. Hyperechoic lobulated mass was detected at interatrial septum by transthoracic echocardiography. Top of the basilar syndrome with a rare skin sign were diagnosed and etiology was hypothesized as embolic phenomena caused by cardiac myxoma embolism. The dermatologic sign was exceptionally rare but the lesion can be a diagnostic clue for embolic mechanism caused by atrial myxoma.

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Published

2019-02-14

How to Cite

1.
Huangsaithong R, Udommongkol C, Intarasupht J, Chinvarun Y. Top of the Basilar Syndrome with Painful Palmar Reticulated Erythematous Patches Complicating Cardiac Atrial Myxoma: A Case Report. J Thai Stroke Soc [Internet]. 2019 Feb. 14 [cited 2024 Jul. 25];14(3):166-71. Available from: https://he01.tci-thaijo.org/index.php/jtss/article/view/172443