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Case Reports in Radiology
Volume 2012, Article ID 690903, 2 pages
Case Report

“Heart Appearance” Infarction of the Pons: A Case Report

Department of Neurology, Faculty of Medicine, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan

Received 10 August 2012; Accepted 17 September 2012

Academic Editors: G. Bastarrika, E. Bölke, E. Kapsalaki, and D. P. Link

Copyright © 2012 Keisuke Ishizawa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


“Heart appearance” on magnetic resonance imaging (MRI) is a unique presentation of bilateral medial medullary infarction. In contrast, “heart appearance” infarction of the pons has rarely been featured in the medical literature. In this paper, we present a case of “heart appearance” infarction of the pons with its MRI and magnetic resonance angiography (MRA) findings. The patient was an 87-year-old male who manifested with weakness in the four extremities. Later, bulbar palsy and tetraplegia became apparent, and he eventually was trapped in locked-in syndrome. Brain MRI disclosed a “heart appearance” lesion in the pons, which was high on diffusion-weighted image MRI and low on apparent diffusion coefficient map MRI. Brain MRA demonstrated that the basilar artery remained intact. A diagnosis of fresh, bilateral pontine infarction with a “heart appearance” was made. After the treatment he was transferred to another hospital for long-term care. This case suggests that bilateral ischemic involvement of the pons is possible even in the context of an intact basilar artery.