Heart sign (medulla)

Last revised by Rohit Sharma on 28 Feb 2024

The heart sign, also known as the AirPod sign, is a radiological sign described in bilateral medial medullary ischemic stroke. Bilateral medial medullary stroke is a very rare location for stroke and can occur due to disease of the basilar artery, vertebral arteries, or anterior spinal artery 1,2.

The heart sign refers to the appearance of the infarct on axial DWI MRI, whereby there is bilateral high diffusion signal in the medulla oblongata that takes the shape of a heart or a pair of Apple AirPod headphones 1-4. A similar appearance has also been described in one case report in the pons in bilateral medial pontomedullary junction ischemic stroke 5.

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