Department of Neurology, Sahloul Hospital, Sousse, Tunisia
Research Article
Favorable Primary Outcome of Bilateral Medial Medullary Infarction: A Case Report
Author(s): Rabiaa Douma*, Bissen Douma, Ben Halima Manel, Mama Nadia, Jemni Hela and Ben Amor Sana
Bilateral Medial Medullary Infarction (MMI) is a rare stroke subtype. Quadriplegia, sensory disturbance, hypoglossal
palsy and bulbar paralysis are the most common symptoms but clinical diagnosis without neuroimaging is very
difficult.
We report a patient, with a past medical history of diabetes and hypertension, who presented to the emergency with
sudden left hemiparesis. After 24 hours, he presented a motor weakness of the right side. Initial brain scan objected
only old ischemic lesions. Brain MRI was requested showed characteristic “heart appearance” sign at Diffusion
Weighted Imaging (DWI), confirmed bilateral medial medullary stroke. The differential diagnosis such as spinal
infraction or Guillan baree syndrome was eliminated by spine MRI and lumbar function.
The main aetiologyof MMI is vertebral artery atherosclerosis and thrombosis.. View more»