To report a case of cardiac intimal sarcoma presenting as basilar artery occlusion and discuss management strategies, highlighting its rarity and implications for clinical practice.
Key Findings:
Cardiac intimal sarcoma can present as acute basilar artery occlusion.
Intravenous tenecteplase was administered despite unrecognized thrombocytopenia, leading to significant bleeding complications, which underscores the risks of thrombolytic therapy in patients with malignancy-related coagulopathy.
Mechanical thrombectomy successfully retrieved a large thrombus, improving blood flow but not preventing subsequent multi-organ failure, highlighting the complexity of managing such cases.
Interpretation:
The case underscores the importance of considering cardiac tumors in patients with embolic strokes and the critical need for rapid laboratory assessments to mitigate risks associated with thrombolytic therapy in the presence of malignancy-related coagulopathy.
Limitations:
The case is a single patient report, limiting generalizability and potential biases in case reporting.
Thrombocytopenia was identified post-thrombolysis, highlighting the need for rapid laboratory assessments to inform treatment decisions.
Conclusion:
This case illustrates the potential for cardiac intimal sarcoma to manifest as acute neurological events and emphasizes the need for careful patient selection for thrombolytic therapy, as well as the importance of multidisciplinary management in such complex cases.
