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[A Case of Bilateral Medial Medullary Infarction With Heart Appearance Sign]

Hirotsugu Ohta1, Takeru Umemura1, Hirohisa Kondoh1

  • 1Department of Neurosurgery, MOJI Medical Center, Kitakyushu.

Journal of UOEH
|December 4, 2022
PubMed

Insights

A rare heart appearance sign on diffusion-weighted images indicates bilateral medial medullary infarction. Early diagnosis of this stroke pattern may predict a poor patient outcome.

Area of Science:

  • Neurology
  • Radiology

Background:

  • Medial medullary infarction is a rare type of stroke affecting the brainstem.
  • The anterior spinal artery typically supplies the medial medulla oblongata.

Observation:

  • A unique 'heart appearance sign' was observed on diffusion-weighted MRI in a patient with bilateral medial medullary infarction.
  • This sign presented as high-intensity lesions in the bilateral medial medulla oblongata.

Findings:

  • The patient, an 85-year-old male, presented with dysarthria and quadriparesis.
  • Despite initial worsening, the patient showed improvement without bulbar paralysis, suggesting potential for recovery.
  • The 'heart appearance sign' on diffusion-weighted imaging may serve as an early indicator of stroke severity.

Implications:

  • Early recognition of the 'heart appearance sign' could aid in predicting stroke outcomes.
  • Understanding the vascular supply of the medial medulla is crucial for diagnosing and managing these specific infarcts.
  • This case highlights the importance of advanced neuroimaging in identifying rare stroke patterns.

Keywords:
bilateralheart appearance signmedial medullary infarction

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