“Heart Appearance” Infarction of the Pons : A Case Report

Abstract EN

“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.