Raj Aiswarya, Alapatt Paul J, R Arya, L K Sreevidya, V V Ashraf
Department of Neurology, Aster Malabar Institute of Medical Sciences (MIMS), Kozhikode, IND.
Cureus. 2022 Dec 2;14(12):e32129. doi: 10.7759/cureus.32129. eCollection 2022 Dec.
Quadriplegia or dysesthesia in all four limbs may be the initial symptom of bilateral medial medullary infarction (MMI), a very rare cerebrovascular accident with a dismal prognosis. Clinical diagnosis of bilateral MMI is still challenging and can be confirmed by diffusion-weighted (DW) magnetic resonance imaging (MRI) in the early stage. Here, we report the case of a 60-year-old male who presented to the emergency department complaining of numbness in all four limbs. DW-MRI was used to identify brain lesions 24 hours after the symptom onset. The infarct, on axial MRI sections, showed the characteristic 'airpod sign'/heart-shaped appearance due to the morphology of the area involved in the medulla.
四肢瘫痪或四肢感觉异常可能是双侧延髓内侧梗死(MMI)的初始症状,这是一种非常罕见的脑血管意外,预后很差。双侧MMI的临床诊断仍然具有挑战性,早期可通过弥散加权(DW)磁共振成像(MRI)确诊。在此,我们报告一例60岁男性病例,该患者因四肢麻木到急诊科就诊。症状出现24小时后使用DW-MRI来识别脑部病变。在轴向MRI切片上,梗死灶由于延髓受累区域的形态而呈现出特征性的“AirPod征”/心形外观。