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"Heart appearance" infarction of the pons: a case report

Keisuke Ishizawa1, Mikiko Ninomiya, Yoshihiko Nakazato

  • 1Department of Neurology, Faculty of Medicine, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.

Case Reports in Radiology
|October 25, 2012
PubMed

Insights

A rare "heart appearance" lesion in the pons was identified via magnetic resonance imaging (MRI) in an 87-year-old male. This case highlights bilateral pontine infarction, even with an intact basilar artery.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • The
  • heart appearance
  • sign on magnetic resonance imaging (MRI) is typically associated with bilateral medial medullary infarction.
  • Infaractions of the pons exhibiting this
  • heart appearance
  • are infrequently documented in medical literature.

Purpose of the Study:

  • To present a rare case of
  • heart appearance
  • infarction in the pons.
  • To detail the magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) findings associated with this condition.

Main Methods:

  • Case study of an 87-year-old male patient.
  • Utilized brain MRI, including diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping.
  • Performed brain MRA to assess the basilar artery.

Main Results:

  • The patient presented with progressive neurological deficits, including tetraplegia and bulbar palsy, leading to locked-in syndrome.
  • Brain MRI revealed a characteristic
  • heart appearance
  • lesion in the pons, with high signal intensity on DWI and low signal intensity on ADC maps.
  • Brain MRA showed an intact basilar artery, despite the bilateral pontine infarction.

Conclusions:

  • This case demonstrates a rare instance of bilateral pontine infarction presenting with a
  • heart appearance
  • on MRI.
  • It suggests that bilateral ischemic involvement of the pons can occur independently of basilar artery patency.

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