Bilateral Medial Medullary Infarct with Unique Radiological Presentation

Çakmakci G., Çetiner M., Uysal N., Arikan F. A., Kabay S. C.

Acta neurologica Taiwanica, vol.33(1), pp.14-18, 2024 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 33(1)
  • Publication Date: 2024
  • Journal Name: Acta neurologica Taiwanica
  • Journal Indexes: Scopus, EMBASE
  • Page Numbers: pp.14-18
  • Kütahya Health Sciences University Affiliated: Yes


Bilateral medial medullary infarction is a rare subtype of stroke.The typical heart-shaped appearance on magnetic resonance imaging is pathognomonic for bilateral medial medullary syndrome. Vertebrobasilar dolichoectasia is a condition characterized by tortuous dilatation and marked enlargement of the basilar and vertebral arteries, and it may cause posterior circulation infarction. We present the case of a 55-year-old female patient with complaints of speech disorder, regression in consciousness, and difficulty breathing. Diffusion-weighted imaging examination was normal on arrival. In the cranial imaging after 24 hours, acute infarction was observed in the bilateral medial medullary area. Time-of-flight magnetic resonance angiography revealed vertebrobasilar dolichoectasia. In this report, a case of bilateral medial medullary infarction with a unique radiological appearance accompanied by vertebrobasilar dolichoectasia, which is rarely reported in the literature, is presented. Keywords: Stroke, infarct, bilateral medial medullary infarction, heart appearance.