Sequential Pontine Strokes With the "Heart Appearance" Sign
Carlos Eduardo A Mantese1, Mariana Pontalti1, Alexandre Guerreiro1
1Neurology, Hospital Mãe de Deus, Porto Alegre, BRA.
Cureus
|June 21, 2021
Summary
Sequential pontine strokes, though rare, can cause the "heart appearance" sign on brain imaging. This case highlights an unusual stroke recurrence and its potential cause.
Area of Science:
- Neurology
- Radiology
Background:
- Pontine strokes are a common cause of brainstem infarcts.
- Bilateral pontine strokes can manifest as the
Observation:
- A 47-year-old man presented with sequential pontine strokes over two weeks.
- Initial MRI revealed a right pontine infarct, followed by a left pontine infarct.
- The patient experienced worsening hemiparesis, dysarthria, and developed facial paralysis.
Findings:
- The sequential left pontine infarction created the characteristic
Implications:
- This case demonstrates an atypical presentation of pontine stroke recurrence.
- Branch artery disease is proposed as a potential etiological factor.
- Highlights the importance of considering sequential infarcts in pontine stroke imaging.
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