Presentation
Elderly male with sudden onset loss of consciousness. GCS 3.
Patient Data



Non-contrast CT demonstrates a large pontine hemorrhage with extension of blood into the fourth ventricle and up into the third ventricle. The temporal horns are a little prominent as are the lateral ventricles suggesting developing hydrocephalus.



Large pontine hemorrhage (*) has extended into the forth ventricle (V4), up the aqueduct of Sylvius (AQ) and into the third ventricle (V3). The lateral ventricles (LV) and their temporal horns (TH) are a little prominent, although this is in part due to age related ex vacuo dilatation.
Case Discussion
This patient passed away shortly after admission. Presumably this bleed is due to unrecognised hypertension, although no previous history was available.