双侧脑桥延髓交界区梗死磁共振成像上的巨大“心脏样征”：病例报告
Giant "heart appearance-like sign" on MRI in bilateral ponto-medullary junction infraction: case report.
作者信息
Zhou Zhi-Hua, Wu Yun-Fan, Wu Wei-Feng, Liu Ai-Qun, Yu Qing-Yun, Peng Zhong-Xing, Hong Ming-Fan
机构信息
Department of neurology, The first affiliated hospital, School of Clinical Medicine of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China.
Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China.
出版信息
BMC Neurol. 2020 Mar 23;20(1):107. doi: 10.1186/s12883-020-01683-7.
BACKGROUND
Bilateral medial medullary infarction (MMI) is uncommon and bilateral medial pons infarction (MPI) is even rarer. "Heart appearance" on magnetic resonance imaging (MRI) is a characteristic presentation of bilateral medial medullary infarction (MMI).
CASE PRESENTATION
We present 67-year-old Chinese diabetic and hypertensive female patient affected with "heart appearance-like" infarction in bilateral ponto-medullary junction on MRI. Abnormal signal was observed in the bilateral ponto-medullary junction on T1, T2, fluid-attenuated inversion recovery and apparent diffusion coefficient (ADC). The whole brain digital subtraction angiography (DSA) showed the basilar artery and vertebral artery remained intact. Therefore, we speculated that the bilateral ponto-medullary junction infarction might be caused by the deep perforating branch of the basilar artery.
CONCLUSIONS
As far as we know, the "heart appearance-like" infraction in bilateral ponto-medullary junction was not reported. Our case also suggests that bilateral ischemic infraction involvement of the medulla and pon is possible even in the context of an intact basilar artery.
背景
双侧延髓内侧梗死（MMI）并不常见，双侧脑桥内侧梗死（MPI）则更为罕见。磁共振成像（MRI）上的“心形表现”是双侧延髓内侧梗死（MMI）的特征性表现。
病例报告
我们报告了一名67岁的中国女性糖尿病和高血压患者，MRI显示双侧脑桥延髓交界处出现“类心形”梗死。在T1、T2、液体衰减反转恢复序列和表观扩散系数（ADC）上，双侧脑桥延髓交界处观察到异常信号。全脑数字减影血管造影（DSA）显示基底动脉和椎动脉保持完整。因此，我们推测双侧脑桥延髓交界处梗死可能由基底动脉的深穿支引起。
结论
据我们所知，双侧脑桥延髓交界处的“类心形”梗死尚未见报道。我们的病例还表明，即使在基底动脉完整的情况下，双侧延髓和脑桥的缺血性梗死也是可能的。
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