Pontine hemorrhage

Case contributed by Frank Gaillard
Diagnosis certain

Patient Data

Age: 35
Gender: Male
ct
This study is a stack
Coronal
non-contrast
This study is a stack
Sagittal
non-contrast
This study is a stack
Axial
non-contrast
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Info

There is a large focus of intra-axial hemorrhage within the pons measuring 2.8 x 1.4 x 1.8 cm. There is mass-effect upon the 4th ventricle which is partially effaced. No hydrocephalus. No other focus of intracranial hemorrhage identified. No signs of acute infarction. The basal cisterns are unremarkable. Opacification of the right maxillary sinus is likely chronic.

Conclusion:

Large pontine intra-axial hemorrhage with effacement of the 4th ventricle. No hydrocephalus.

Case Discussion

This patient had documented, long-standing, poorly controlled hypertension, and has gone on to have a CTA and MRI which demonstrated no underlying lesion. 

The pons, along with the basal ganglia and cerebellar hemispheres, is a typical locations for a hypertensive hemorrhage. 

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