Tetraplegia Following Bilateral Medial Medullary Infarction

Bilateral medial medullary infarction is rare. We report a 54-year-old man who presented with a 3-day history of dysarthria and progressive weakness in all four limbs. He suffered from respiratory failure 10 days later. Brain magnetic resonance imaging showed acute infarction of the bilateral medial medulla, characterized by a typical heart-shaped sign. Intravenous heparin was given for his cerebral infarction; the patient survived but with tetraplegia. Respiratory failure caused by bilateral medial medullary infarction can be fatal. With improvements in diagnostic technology, and the application of appropriate respiratory care, the survival rate of patients with bilateral medial medullary syndrome has increased. Early diagnosis with adequate treatment of respiratory symptoms may improve the clinical outcome. [Tzu Chi Med J 2009;21(3):248–250] Article info Article history: Received: June 3, 2008 Revised: July 2, 2008 Accepted: November 14, 2008