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.
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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 haemorrhage with no hydrocephalus.
The findings highly in favour a pontine haemorrhage.
Normal brain parenchyma, no SOL, no midline shift and normal cerebellar hemispheres.
The pons is a typical site for hypertension-associated cerebral haemorrhage. It carries a very poor prognosis.
The cause of haemorrhage in this patient is likely secondary to the patient's uncontrolled hypertension.