Patient Data
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. O pacification 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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