Pontine hemorrhage

Case contributed by Dr Karwan T. Khoshnaw


An elderly male patient who is a known case of uncontrolled hypertension presented with irritability and disturbed consciousness. BP was 190/100 mmHg at presentation. During clinical examination the patient developed an attack of seizure followed by dyspnea, cyanosis and loss of consciousness.

Patient Data

Age: 65
Gender: Male

A well-defined intra-axial oval-shaped area of homogenously hyperdensity (recent blood density) is seen in the pontine region.The lesion measures 22x17mm in maximal transverse diameter.The lesion exerts no mass effect.  No associated intraventricular hemorrhage with no hydrocephalus.

The findings highly in favor a pontine hemorrhage.

Normal brain parenchyma, no SOL, no midline shift and normal cerebellar hemispheres.

Case Discussion

The pons is a typical site for hypertension-associated cerebral hemorrhage. It carries a very poor prognosis.

The cause of hemorrhage in this patient is likely secondary to the patient's uncontrolled hypertension. 

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