alexa The Heart-sign of Bilateral Medial Medullary Infarction
ISSN: 2329-6895

Journal of Neurological Disorders
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Case Report

The Heart-sign of Bilateral Medial Medullary Infarction

Pedro Radalle Biasi1*, Grégori Manfroi2, Timóteo Abrantes de Lacerda Almeida1, Luciano Bambini Manzato1,3

1Department of Neurosurgery, São Vicente de Paulo Hospital, Passo Fundo, Brazil

2University of Passo Fundo - School of Medicine, Passo Fundo, Brazil

3Service of Neurology and Neurosurgery, Passo Fundo, Brazil

Corresponding Author:
Pedro Radalle Biasi
Department of Neurosurgery, São Vicente
de Paulo Hospital, Passo Fundo, Brazil
Tel: +555496172514
E-mail: [email protected]

Received date: Apr 19, 2016; Accepted date: Jun 21, 2016; Published date: Jun 24, 2016

Citation: Biasi PR, Manfroi G, Almeida TAL, Manzato LB (2016) The Heart-sign of Bilateral Medial Medullary Infarction. J Neurol Disord 4:269. doi:10.4172/2329-6895.1000269

Copyright: © 2016 Biasi PR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



The Bilateral Medial Medullary Infarction presents with progressive tetraparesis, bilateral profound sensory loss, dysphagia and dysarthria, progressing to respiratory failure, which can be misdiagnosed with Guillain-Barré syndrome. The main cause its vertebral artery atherosclerosis and thrombosis affecting the anteromedial (supplied by branches of vertebral artery and anterior spinal artery) and anterolateral (fed by short and long transverse branches of vertebral artery) territories of medulla bilaterally. The diagnosis is facilitated by Diffusion Weighted Image and ADC-map on MRI, which shows a V-shape infarction, or, as known, the “heart sign” (Figure 1 and Figure 2), which is typical of this disease. The outcome is poor, with high mortality.


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