A stroke involving the pons can be caused by either a blood clot ischemic stroke or a bleed hemorrhagic stroke. An ischemic stroke occurs when a blood clot blocks the blood flow through an artery to a certain region in the brain. A hemorrhagic stroke occurs when a blood vessel ruptures, reducing or halting the flow of blood to a region in the brain.
Whether a stroke is ischemic or hemorrhagic, once the blood supply to a region of the brain is interrupted, brain cells begin to die, resulting in brain damage. The bleeding of hemorrhage can also cause damage due to pressure and irritation to nearby brain structures.
The physical and cognitive memory, thinking abilities controlled by the area of the brain where a stroke occurs become affected. The extent of damage depends on the location and size of the stroke. In rare instances, a stroke involving the pons, typically called a pontine stroke, may be the result of an injury to an artery caused by sudden head or neck trauma.
This can happen because the blood vessels that supply blood to the pons and the rest of the brainstem are located in the back of the neck, and may become injured as result of neck trauma or sudden pressure or movements of the head or neck. Diagnosis of a pontine stroke requires a thorough neurologic examination. Some diagnostic imaging tests, such as brain magnetic resonance imaging MRI and brain magnetic resonance angiography MRA or computerized tomography CT angiogram, can help confirm the diagnosis of a pontine stroke.
Stroke treatment depends on getting medical attention as soon as possible. Treatment with the clot-dissolving drug tissue plasminogen activator tPA can be effective for the treatment of ischemic stroke only if it is administered within three hours of the onset of stroke symptoms. Stroke treatment guidelines published jointly by the American Heart Association and American Stroke Association in strongly recommend the use of tPA in eligible patients, but note that doctors need to evaluate patient eligibility before administering this treatment.
Factors that play a role in eligibility include age, blood sugar levels, and blood pressure. In certain patients, tPA can be used up to 4. During recovery after a stroke, there are several stroke treatments that can help maximize improvement, including blood thinners, fluid management, treatment of heart problems, and maintaining adequate nutrition. Recovery from a pontine stroke is possible. If you have experienced a pontine stroke, once your symptoms stabilize over time, the focus of your recovery will be based on preventing complications such as choking and preventing further strokes from happening.
Strokes in the brain stem do not affect language ability, and this makes it easier to participate in rehabilitation therapy. Vertigo and double vision typically resolve if the stroke is mild or moderate. Physical therapy and rehabilitation are important components of stroke recovery. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life.
Hocker S, Wijdicks E. Recovery from locked-in syndrome. JAMA Neurol. American Stroke Association. Brain stem stroke. Author Contributions: Dr Saposnik had full access to all the data in the study and had final responsibility for the decision to submit the manuscript for publication.
Study concept and design : Saposnik. Acquisition of data : Saposnik. Analysis and interpretation of data : Saposnik, Noel de Tilly, and Caplan. Drafting of the manuscript : Saposnik and Noel de Tilly. Critical revision of the manuscript for important intellectual content : Saposnik and Caplan. Obtained funding : Saposnik. Administrative, technical, and material support : Saposnik. Study supervision : Caplan.
Role of the Sponsor: None of the supporting agencies had a role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.
Pontine Warning Syndrome. Arch Neurol. Coronavirus Resource Center. Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. Save Preferences. Privacy Policy Terms of Use. Twitter Facebook. This Issue. Citations View Metrics. October Caplan, MD. Report of a case. View Large Download. Further investigations are needed to evaluate the long-term prognosis in more patients of the pontine infarction with PMH or hemiplegia.
This study suggests that the pontine infarction with PMH or hemiplegia is a common clinical situation, which is worth receiving more attention. This subtype of pontine infarction patients might manifest PMH or hemiplegia, with nonvertiginous dizziness, a progressive course and the history of diabetes mellitus being more frequently. Though no visible lesion on brain CT on admission, MRI can confirm the infarct location in the basal pons at early stage after stroke onset.
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Eur Neurol. J Neurol Sci. BMC Neurol. Prog Cardiovasc Dis. Fisher CM: Lacunar strokes and infarcts: a review. Clin Neurol Neurosurg. Bogousslavsky J, Regli F, Maeder P, Meuli R, Nader J: The etiology of posterior circulation infarcts: a prospective study using magnetic resonance imaging and magnetic resonance angiography. Can J Neurol Sci. PubMed Google Scholar. Accuracy of very early clinical diagnosis of lacunar strokes.
Arch Intern Med. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Jinsheng Zeng. LL acquired data, performed statistical analysis, analyzed and interpreted data, and wrote and critically revised the manuscript. LZ acquired data, performed statistical analysis, analyzed and interpreted data. JZ designed and the study, obtained funding, performed the statistical analysis, interpreted the results and critically revised the manuscript.
All authors read and approved the final manuscript. Reprints and Permissions. Ling, L. Pontine infarction with pure motor hemiparesis or hemiplegia: A prospective study. BMC Neurol 9, 25 Download citation.
Received : 26 December Accepted : 15 June Published : 15 June Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background The study aimed to prospectively observe the clinical and neuroimaging features of pontine infarction with pure motor hemiparesis PMH or hemiplegia at early stage.
Methods In consecutive selected patients with the first-ever ischemic stroke within 6 hours after onset, fifty of them presented with PMH or hemiplegia and had negative acute computed tomography CT scans, then magnetic resonance imaging MRI confirmed the corresponding infarcts in pons or cerebrum. Results The pontine infarction with PMH or hemiplegia accounted for Conclusion The pontine infarction may present as PMH or hemiplegia with more frequency of nonvertiginous dizziness, a progressive course and diabetes mellitus.
Background Pontine infarction is usually manifested by classical crossed syndromes such as Millard-Gubler syndrome, Foville syndrome, Raymond-Cestan syndrome [ 1 ]. Methods Patients We prospectively selected consecutive patients with the first-ever ischemic stroke, who were admitted to our stroke center within 6 hours after symptom onset from May 1, to June 30,
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