Perioperative Bilateral Medial Medullary Infarction With “Snake Eyes Appearance”: A Case Report

Yicheng Xu; Ke Li; Xinlu Yao; Qiyan Yang; Peifu Wang

doi:10.3389/fmed.2021.559381

Frontiers in Medicine (Sep 2021)

Perioperative Bilateral Medial Medullary Infarction With “Snake Eyes Appearance”: A Case Report

Yicheng Xu,
Ke Li,
Xinlu Yao,
Qiyan Yang,
Peifu Wang

Affiliations

Yicheng Xu: Department of Neurology, Aerospace Center Hospital, Beijing, China
Ke Li: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Xinlu Yao: Department of Neurology, Aerospace Center Hospital, Beijing, China
Qiyan Yang: Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
Peifu Wang: Department of Neurology, Aerospace Center Hospital, Beijing, China

DOI: https://doi.org/10.3389/fmed.2021.559381
Journal volume & issue: Vol. 8

Abstract

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Perioperative bilateral medial medullary infarction (BMMI) cases mimicking acute motor axonal neuropathy (AMAN) under general anesthesia have not been reported. We describe a patient who suffered flaccid quadriplegia and could not wean from mechanical ventilation after emergence from general anesthesia in cardiac surgery. A diagnosis of AMAN was considered, but intravenous immunoglobulin showed little efficacy. Magnetic resonance imaging of the patient later revealed BMMI with “snake eyes appearance,” and he was found to have severe vertebral artery stenosis. Considering the association between severe coronary heart disease and cerebrovascular stenosis, we highlight the significance of preoperative evaluation and comprehensive management of the cerebrovascular system for certain patients.

Published in Frontiers in Medicine

ISSN: 2296-858X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Medicine (General)
Website: http://www.frontiersin.org/journals/medicine

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Abstract

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