title: A case of bilateral medial medullary infarction presenting with "heart appearance" sign.
abstract: Bilateral medial medullary infarction (bilateral MMI) is an extremely rare cerebrovascular accident presenting with quadriplegia as the initial symptom and resulting in poor functional prognosis. Diagnosis of bilateral MMI has become possible based on brain MRI findings in recent years, but is still very difficult to diagnose. In the present case, brain MRI was performed 9 hours after the onset, and the infarcted area was detected only by diffusion-weighted MRI. However, changes over time were clearly detected by FLAIR-MRI on days 3, 5 and 7, but it is essential to confirm the disease by DW-MRI in the early stage.The infarct observed on horizontal MRI sections showed the characteristic "heart appearance" sign. For an early diagnosis of bilateral MMI, it is essential to bear in mind that characteristic findings may be obtained by diffusion-weighted MRI.
authors.affiliation: Department of Neurology, Tokai University Hachioji Hospital, 1838 Ishikawa, Hachioji, Tokyo 192-0032 Japan. tokuoka.kentaro@hachioji-hosp.tokai.ac.jp
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tokuoka
authors.forename: Naoki
authors.initials: N
authors.lastname: Yuasa
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Michiko
authors.initials: M
authors.lastname: Takahashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mandokoro
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Takagi
mesh_terms: D001921:Brain / Q000098:blood supply; D020526:Brain Stem Infarctions / Q000150:complications / Q000175:diagnosis; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011782:Quadriplegia / Q000175:diagnosis / Q000209:etiology