Treatment of Massive Pontine Hemorrhage


One of the most common sites of spontaneous intracranial bleeding is the pons. Lesion at the pons may cause significant neurological deficits as you can see at the ER department or Stroke unit. As a part of the brainstem, the pons relays neural signal from cerebrum and cerebellum to organs all over the body. It connects with the reticular formation, cardiovascular and respiratory centers, which play important roles necessary for life. Until now, there are no standard treatment guidelines for the Primary Pontine Hemorrhage (PPH). Yet, there are many retrospective studies about the correlation between the mortality rate and the functional score at the onset of stroke which can be used to imply the prognosis of patients and also to plan for a treatment.

There is a poor prognosis for pontine haemorrhages, with massive bleeds almost always fatal. Open surgical evacuation of the clot is generally not performed, although some have suggested stereotactic clot aspiration. As is the case with penetrating arteries in the basal ganglia, due to poorly regulated hypertension, penetrating arteries from the basilar artery that stretch into the pons are subject to lipohyalinosis

Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition that persistently increases blood pressure throughout the arteries. Nevertheless, elevated blood pressure is a significant risk factor for coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease and dementia.

Bleeding, also known as hemorrhage, haemorrhage, or simply blood loss, is blood that escapes damaged blood vessels from the circulatory system. Bleeding may occur either internally or externally through a natural opening such as the mouth, nose, ear, urethra, vagina, or anus, or through a skin wound. Hypovolemia is a significant reduction in blood volume, and death from premature blood loss is known as exsanguination

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Editorial Team