"Heart Appearance" Infarction of the Pons: A Case Report. (9th October 2012)

• Record Type: Journal Article
• Authors: Ishizawa, Keisuke; Ninomiya, Mikiko; Nakazato, Yoshihiko; Yamamoto, Toshimasa; Araki, Nobuo
• Other Names: Bastarrika G. Academic Editor.; Bölke E. Academic Editor.; Kapsalaki E. Academic Editor.; Link D. P. Academic Editor.
• Is Part Of: Case reports in radiology. Volume 2012(2012)
• Publication Date: 2012-10-09
• Subjects: Radiology -- Periodicals; Radiology -- Case studies -- Periodicals; Medical radiology -- Periodicals; Radiology; Radiology; Medical radiology; Periodicals; Electronic journals; Case studies; Periodicals; 616.0757
• DOI: 10.1155/2012/690903
• Languages: English
• ISSNs: 2090-6862

Abstract

Abstract : "Heart appearance" on magnetic resonance imaging (MRI) is a unique presentation of bilateral medial medullary infarction. In contrast, "heart appearance" infarction of the pons has rarely been featured in the medical literature. In this paper, we present a case of "heart appearance" infarction of the pons with its MRI and magnetic resonance angiography (MRA) findings. The patient was an 87-year-old male who manifested with weakness in the four extremities. Later, bulbar palsy and tetraplegia became apparent, and he eventually was trapped in locked-in syndrome. Brain MRI disclosed a "heart appearance" lesion in the pons, which was high on diffusion-weighted image MRI and low on apparent diffusion coefficient map MRI. Brain MRA demonstrated that the basilar artery remained intact. A diagnosis of fresh, bilateral pontine infarction with a "heart appearance" was made. After the treatment he was transferred to another hospital for long-term care. This case suggests that bilateral ischemic involvement of the pons is possible even in the context of an intact basilar artery.