Presentation
Patients present with sudden and precipitous neurological deficits. [radiopaedia.org]
Skull base chondrosarcomabe is to be included in the differentials of a young patient presenting with signs consistent with pontine haemorrhage. Publication Journal of College of Physicians and Surgeons Pakistan [ecommons.aku.edu]
Mohr Medicine Neurology 1980 Two hypertensive men presented clinically with small, largely unilateral hematomas of the pons and midbrain demonstrated by computerized tomography. [semanticscholar.org]
Superior Foville syndrome is a rare clinical presentation of stroke and presented a rich semiological feature of the posterior cerebral fossa. Introduction The Superior Foville Syndrome is a rare clinical feature of stroke or brain hemorrhage. [panafrican-med-journal.com]
Clinical tuberculoma of pons presenting as Foville’s syndrome. J Indian Med Assoc 1973; 61 :184–5. 8. Levene LJ. Benign cerebellar tumor presenting a modified Foville syndrome. J Am Geriatr Soc 1958; 6 :346–51. 9. [e-tjo.org]
Entire Body System
- Collapse
He has been extremely fit and active throughout his life, used to walk long, dance as a part of senior citizen group, until on 6th Dec. 2013, afternoon when he suddenly complained of severe headache and then collapsed with mild paralytic condition. [medhelp.org]
The fact that he had suddenly collapsed and become comatose when he stood up on his last day of life, has been interpreted as brain herniation and Duret haemorrhages. [11] References [ edit ] ^ Dorland's (2012). [en.wikipedia.org]
Parenchymal hemorrhage disrupts brain tissue and accumulates rapidly within a few hours until pressure from the hematoma collapses the bleeding vessels. The blood clot is surrounded by a zone of compressed ischemic tissue. [neuropathology-web.org]
- Unconsciousness
But since your cousin was found unconscious the morning after, and we are not sure how much time elapsed after the actual hemorrhage, MRI looks appropriate. [medhelp.org]
A massive aneurysmal bleed raises intracranial pressure, resulting in arrest of cerebral perfusion, unconsciousness, and HIE. [neuropathology-web.org]
- Hypothermia
Now you can guess how Bromocriptine and Apomorphine cause Hypothermia. :) -VM [medicowesome.com]
Eyes
- Miosis
Diffusely spreading hypertensive haemorrhages are of apo-plectiform onset with fast developing coma, and show disturbance of vegetative function (disturbance of respiration, cardiac dysrhythmias, hyperthermia, hypertension), miosis and other neuroophthalmologic [ncbi.nlm.nih.gov]
or autonomic instability Cerebellum - Ataxia, usually beginning in the trunk, ipsilateral facial weakness, ipsilateral sensory loss, gaze paresis, skew deviation, miosis, or decreased level of consciousness Causes [ edit ] Hypertension Arteriovenous [en.wikipedia.org]
Mild ptosis with concurrent miosis oculus dexter was also found. A neurological examination revealed left hemiplegia, left hemiparesthesia, left-side sensory ataxia, right facial palsy, and right facial analgesia. [e-tjo.org]
Neurologic examination demonstrated a decreased level of consciousness, bilateral miosis, horizontal gaze paralysis, right ptosis, dysarthria, left hemiplegia, and left tongue deviation. [omicsonline.org]
Urogenital
- Renal Insufficiency
Conclusions Reversible, predominantly posterior leukoencephalopathy may develop in patients who have renal insufficiency or hypertension or who are immunosuppressed. [nejm.org]
Neurologic
- Babinski Sign
Deep tendon reflexes were brisk with bilateral extensor plantar responses and positive Babinski sign. A laboratory evaluation on admission including renal function, hepatic function, serum electrolyte concentrations was unremarkable. [wjgnet.com]
Bilateral Babinski signs were positive. Gradually, his gait also became ataxic and he was unable to walk independently. [omicsonline.org]
sign, and decreased pinprick and touch on the right. [jnnp.bmj.com]
Arm and leg weakness, increased deep tendon reflexes, and upward Babinski sign on neurologic examination may result from damage to the long motor tracts traveling from the brain to the spinal cord, passing through the pons. [childhoodbraintumor.org]
- Ocular Bobbing
Clinical manifestations included “ocular bobbing,”… SHOWING 1-6 OF 6 REFERENCES Ocular bobbing with survival C. ClarkeR. [semanticscholar.org]
Spontaneous downward eye movements - ocular bobbing - imply preservation of rostral brainstem gaze centres. smaller unilateral basal pontine lesions show contralateral hemiparesis, often with ataxia in the limbs affected. lateral tegmental pontine lesions [gpnotebook.co.uk]
bobbing, miosis, or autonomic instability Cerebellum - Ataxia, usually beginning in the trunk, ipsilateral facial weakness, ipsilateral sensory loss, gaze paresis, skew deviation, miosis, or decreased level of consciousness Causes [ edit ] Hypertension [en.wikipedia.org]
- Stupor
Introduction Both acute medical illness and treatment with immunosuppressive drugs are occasionally complicated by neurologic abnormalities, including altered mental function, visual loss, stupor, and seizures. [nejm.org]
His level of consciousness was drowsy at initial presentation, but subsequently worsened to stupor. He showed sudden respiratory difficulty, so underwent endotracheal intubation. [ejao.org]
- Long Tract Signs
Depending on the speed at which the hematoma enlarges and the exact location, presentation may include 1,2 : decreased level of consciousness (most common) long tract signs including tetraparesis cranial nerve palsies seizures Cheyne-Stokes respiration [radiopaedia.org]
Workup
METHODS: Review of all patients with acute pontine hemorrhage admitted to a single tertiary center from 1990 to 2002 who underwent a diagnostic workup including brain magnetic resonance imaging (MRI). [ncbi.nlm.nih.gov]
Methods: Review of all patients with acute pontine hemorrhage admitted to a single tertiary center from 1990 to 2002 who underwent a diagnostic workup including brain magnetic resonance imaging (MRI). [karger.com]
Treatment
Key Words: Pontine hematoma ; Surgical treatment ; Conservative treatment [jkns.or.kr]
Access the comprehensive, expert clinical guidance you need to recognize the clinical manifestations of stroke, use the latest laboratory and imaging studies to arrive at a diagnosis, and generate an effective medical and surgical treatment plan. [books.google.de]
[…] haemangioma, cavernous haemangioma, capillary teleangiectasies), anticoagulative treatment and inflammatory vascular disease. [ncbi.nlm.nih.gov]
Rapid identification and appropriate diagnostics are essential, as prompt treatment usually results in reversal of symptoms; permanent neurologic injury or death can occur with treatment delay. [wjgnet.com]
Prognosis
Treatment and prognosis Pontine hemorrhages have a poor prognosis, with large bleeds being almost universally fatal. Open surgical evacuation of the clot is usually not performed, although stereotactic clot aspiration has been advocated by some 5. [radiopaedia.org]
[…] that prognosis is related to size of the haematoma level of consciousness pupillary abnormalities. [aic.cuhk.edu.hk]
Determination of the baseline and fol- low-up ICH and IVH volumes on NCCT was performed using Analyze Direct 11.0 software” Keywords Brainstem CT angiography Intracerebral hemorrhage Pontine Prognosis Spot sign Author Affiliation(s) 1 Department of Clinical [analyzedirect.com]
"Duret hemorrhage is not always suggestive of poor prognosis: a case of acute severe hyponatremia". Am J Emerg Med. 23 (7): 908–10. doi : 10.1016/j.ajem.2005.07.014. [en.wikipedia.org]
Etiology
The treatment depends on the etiology found, so it is important to realize a complete work up. Competing interests The authors declare no competing interest. [panafrican-med-journal.com]
Etiology 95% of cases have a normal cerebral angiogram and the source of bleeding is not identified; the cause is thought to be a venous bleed. This is referred to as non-aneurysmal perimesencephalic SAH. [radiopaedia.org]
Other associated conditions are hepatic dysfunction / liver transplantation, malnutrition Sites Most commonly central pons Extrapontine sites are cerebellum and lateral geniculate, regions of extensive gray white matter apposition Pathophysiology / etiology [pathologyoutlines.com]
Anterior cerebral artery infarction and aneurysms are common etiologies. The clinical features include reflex grasping, groping, and compulsive tool manipulation by the dominant right hand. [neurologyindia.com]
Chimowitz MI, Furlan AJ, Sila CA, Paranandi L, Beck GJ: Etiology of motor or sensory stroke: A prospective study of the predictive value of clinical and radiological features. Ann Neurol 1991;30:519–525. [karger.com]
Epidemiology
Hsu PK, Rigamonti D, Huhn SL (1993) Epidemiology of cavernous malformations. In: Awad IA, Barrow DL (eds) Cavernous malformations. American Association of Neurological Surgeons, Park Ridge IL, pp 13–23 Google Scholar 4. [springerlink.com]
Definition / general Central pontine and extrapontine myelinolysis are complications of treatment of marked hyponatremia Terminology Also termed osmotic demyelination syndrome Epidemiology Occurs most commonly in setting of chronic alcoholism (~40% of [pathologyoutlines.com]
International epidemiology of intracerebral haemorrhage. CurrAtheroscler Rep. 2012; 14: 300-306 INAGAWA T, OHBAYASHI N, TAKECHI A, SHIBUKAWA M, YAHARA K. [ajns.paans.org]
Basic Facts &Epidemiology Diffuse Intrinsic Pontine Glioma (DIPG)is a devastating, aggressive brain tumor of childhood. It arises in the pons, a region of the brainstem involved in critical body functions. [childhoodbraintumor.org]
Epidemiology Frequency United States Each year, intracerebral hemorrhage affects approximately 12-15 per 100,000 individuals, including 350 hypertensive hemorrhages per 100,000 elderly individuals. [emedicine.medscape.com]
Pathophysiology
Gain fresh perspectives and up-to-date insights from the world’s leading authorities on the pathophysiology, diagnosis, and management of stroke. [books.google.de]
* A comprehensive source that thoroughly examines the neurological manifestations of stroke * A guide to highly studied topics, including stroke complications, syndromes, and stroke related psychiatric disorders * A better understanding of the pathophysiological [books.google.com]
Combat stroke with the most comprehensive and updated multimedia resource on the pathophysiology, diagnosis, and management of stroke from leaders in the field [books.google.ro]
Prevention
Stay up to date on hot topics such as mechanisms of action of commonly used drugs, neuronal angiogenesis and stem cells, basic mechanisms of spasm and hemorrhage, prevention of stroke, genetics/predisposing risk factors, and much more. [books.google.de]
[…] manifestations of stroke * A guide to highly studied topics, including stroke complications, syndromes, and stroke related psychiatric disorders * A better understanding of the pathophysiological basis of strokes that will help practitioners better diagnose, prevent [books.google.com]
Highlights new information on genetic risk factors; primary prevention of stroke; infectious diseases and stroke; recovery interventions such as robotics, brain stimulation, and telerehabilitation; and trial design. [books.google.ro]