Ventral medullary infarct in a young patient with a patent foramen ovale

<h3></h3> We present the case of a 54 year old, previously fit and healthy with no underlying vascular risk factors, who presented with lower limb numbness which rapidly progressed to partial quadriparesis. MRI head imaging confirmed an area of restricted diffusion involving the ventral medulla either side of the midline. As part of his stroke up, he was found to have bilateral lobar pulmonary emboli as well as a patent foramen ovale (PFO). The thrombophilia screen and lumbar puncture results were bland and there was no evidence of malignancy on whole body imaging. He was transferred to a neuro-rehabilitation unit for 7 weeks and made a good recovery and his PFO was closed. A medial medullary infarct is a rare type of brain stem infarction that was first described in 1908. There are a few documented cases typically associated with arteriosclerosis. Our case demonstrates an underlying PFO in relation to the infarct in a young patient.