Airpod Sign: A Diagnostic Radiological Finding of a Rare Cerebrovascular Accident

Abstract

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'/heartshaped appearance due to the morphology of the area involved in the medulla.

Bilateral medial medullary stroke: “The heart sign”

“…A typical MRI findings in BMMS have also been described, including faint or delayed DWI changes [ 5 , 6 ] or an incomplete heart sign in 2 consecutive axial sections [7] . Other names given to the “heart appearance” are “Airpod sign” [8] or “Letter Y sign” [9] .…”

An analysis of clinical characteristics of rare bilateral medial medullary infarction: An observational study

“…[ 2 , 3 ] Quadriplegia or sensory dullness in all 4 limbs may be the initial symptom of BMMI. [ 9 ] Two patients in our study experienced respiratory failure and required tracheostomy placement during their initial hospitalization. Pseudobulbar palsy was present in both patients.…”