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A patient presented with acute neurological deficits, and diffusion-weighted imaging revealed a distinctive pattern resembling a \u201cfidget spinner.\u201d 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.<\/jats:p>","DOI":"10.1177\/17562864261470192","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:53:52Z","timestamp":1785819232000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The \u201cfidget spinner\u201d sign in cardioembolic bilateral medial medullary infarction: an imaging clue to proximal anterior spinal artery occlusion"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6311-0387","authenticated-orcid":false,"given":"Can","family":"\u00c7ubuk","sequence":"first","affiliation":[{"name":"Department of Neurology, Sincan Training and Research Hospital, University of Health Sciences, Gokcek District, 250th Street, Ankara 06949, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2012.03.010"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.05.004"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.4.882"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.559864"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.23.11.1657"},{"key":"e_1_3_4_7_2","first-page":"74","article-title":"Bilateral medial medullary infarction: magnetic resonance imaging and correlative histopathologic findings","volume":"33","author":"Kleinert G","year":"1993","unstructured":"Kleinert G, Fazekas F, Kleinert R, et al. 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