Giant "heart appearance-like sign" on MRI in bilateral ponto-medullary junction infraction: case report

Bilateral medial medullary infarction (MMI) is uncommon and bilateral medial pons infarction (MPI) is even rarer. "Heart appearance" on magnetic resonance imaging (MRI) is a characteristic presentation of bilateral medial medullary infarction (MMI). We present 67-year-old Chinese diabetic...

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Bibliographic Details
Published in:BMC neurology 2020-03, Vol.20 (1), p.107-107, Article 107
Main Authors: Zhou, Zhi-Hua, Wu, Yun-Fan, Wu, Wei-Feng, Liu, Ai-Qun, Yu, Qing-Yun, Peng, Zhong-Xing, Hong, Ming-Fan
Format: Article
Language:English
Subjects:
Angiography
Case Report
Case reports
Case studies
Colonies & territories
Diabetes
Diabetes mellitus
Diagnosis
Diffusion coefficient
Digital subtraction angiography (DSA)
Heart
Heart appearance
Hypertension
Ischemia
Laboratories
Magnetic resonance image (MRI)
Magnetic resonance imaging
Medial medullary infarction (MMI)
Medial pons infarction (MPI)
Medical examination
Medical imaging
Medulla oblongata
Methods
Myocardial infarction
Neuroimaging
Neurology
Paralysis
Pons
Ponto-medullary junction infraction
Stroke
Vertebrae
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Summary:Bilateral medial medullary infarction (MMI) is uncommon and bilateral medial pons infarction (MPI) is even rarer. "Heart appearance" on magnetic resonance imaging (MRI) is a characteristic presentation of bilateral medial medullary infarction (MMI). We present 67-year-old Chinese diabetic and hypertensive female patient affected with "heart appearance-like" infarction in bilateral ponto-medullary junction on MRI. Abnormal signal was observed in the bilateral ponto-medullary junction on T1, T2, fluid-attenuated inversion recovery and apparent diffusion coefficient (ADC). The whole brain digital subtraction angiography (DSA) showed the basilar artery and vertebral artery remained intact. Therefore, we speculated that the bilateral ponto-medullary junction infarction might be caused by the deep perforating branch of the basilar artery. As far as we know, the "heart appearance-like" infraction in bilateral ponto-medullary junction was not reported. Our case also suggests that bilateral ischemic infraction involvement of the medulla and pon is possible even in the context of an intact basilar artery.
ISSN:1471-2377
1471-2377
DOI:10.1186/s12883-020-01683-7