Bilateral'medial infarction in the upper medulla oblongata demonstrated by MRI

Abstract

Bilateral medial medullary infarction is relatively rare. Most of the reported cases have demonstrated a poor prognosis because of medullary respiratory failure. We describe the case of a patient who recovered from a bilateral medial medullary infarction limited to the upper portion of the medulla. The patient was a 63-year-old man with mild hypertension who developed temporary respiratory failure, quadriparesis, and disturbance of deep sensation. Magnetic resonance imaging revealed a small infarct bilaterally in the upper third of the medial territory of the medulla oblongata. A magnetic resonance angiogram demonstrated segmental stenosis in the lower basilar artery and atheroscierotic stenosis of the hypoplastic right vertebral artery. Most of his symptoms subsided within 3 months after the onset of the infarction. Our findings suggest that the prognosis of bilateral medial medullary infarct is not necessarily poor.