GOOD NEWS: We have fixed the DICOM uploading problem. New cases should work fine. More info radiopaedia.org/chat

Pontine hemorrhage

Case contributed by Karwan T. Khoshnaw
Diagnosis certain

Presentation

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
ct

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. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.