Bilateral pontine infarction
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At the time the case was submitted for publication Maximiliano Darakdjian had no recorded disclosures.View Maximiliano Darakdjian's current disclosures
A previously healthy woman presented to ER with dysarthria and acute quadriparesis associated with sensory deficits.
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Brain MRI showed a heart-appearance area with restricted diffusion involving the anteromedial region of the mid-pons bilaterally. Subtle enhancement on T1 C+ of the restricted area is also noted. There is also right PICA infarction. The basilar artery appeared intact on MRI. Findings are compatible with acute/subacute infarct of the posterior circulation.
This clinical picture is compatible with bilateral pontine infarct (posterior circulation). The heart-appearance sign is attributed to the involvement of bilateral paramedian and short circumferential pontine arteries.
- 1. Sen D, Arora V, Adlakha S, Gulati Y, Doppaladudi A, Tiwary S. The “Heart Appearance” Sign in Bilateral Pontine Infarction. J Stroke Cerebrovasc Dis. 2015;24(1):e21-4. doi:10.1016/j.jstrokecerebrovasdis.2014.08.009 - Pubmed
- 2. Ishizawa K, Ninomiya M, Nakazato Y, Yamamoto T, Araki N. “Heart Appearance” Infarction of the Pons: A Case Report. Case Reports in Radiology. 2012;2012:1-2. doi:10.1155/2012/690903 - Pubmed
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