The “fidget spinner” sign in cardioembolic bilateral medial medullary infarction: an imaging clue to proximal anterior spinal artery occlusion
Therapeutic Advances in Neurological Disorders, cilt.19, ss.1-12, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 19
- Basım Tarihi: 2026
- Doi Numarası: 10.1177/17562864261470192
- Dergi Adı: Therapeutic Advances in Neurological Disorders
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals, Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.1-12
- Anahtar Kelimeler: anterior spinal artery, bilateral medial medullary infarction, cardioembolism, diffusion-weighted imaging, vertebral artery hypoplasia
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Bilateral medial medullary infarction is a rare and clinically severe form of brainstem stroke. A patient presented with acute neurological deficits, and diffusion-weighted imaging revealed a distinctive pattern resembling a “fidget spinner.” CT angiography demonstrated marked asymmetry of the vertebral arteries, with hypoplasia of the right vertebral artery. A review of 97 previously reported cases confirmed the exceptional rarity of cardioembolic etiology in this condition. In this context, the present case represents an uncommon coexistence of a rare anatomical pattern and a rare vascular mechanism. These findings suggest that infarct morphology on diffusion-weighted imaging may reflect underlying vascular anatomy and the level of arterial involvement in bilateral medial medullary infarction.