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.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9805749PMC
http://dx.doi.org/10.7759/cureus.32129DOI Listing

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