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"Heart appearance" infarction of the pons: a case report.
[locked-in syndrome]
"
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
.