Primary pontine hemorrhage: clinico-computed tomographic correlations.

A series of 10 patients with primary pontine hemorrhage with CT confirmation is reported. All patients were hypertensive. Seven patients had classical pontine hematoma syndrome characterized by decreasing levels of consciousness, quadriparesis, and eventual demise. The three other patients had atypical or partial clinical features of pontine hemorrhage and good prognosis. The pontine hemorrhage can be divided into 4 groups from the viewpoint of location of the hematomas. There are bilateral tegmentobasis (massive) type, hemipontine type, localized tegmentum type, and localized basis type. There was no evidence of ventricular extension in all 10 cases. All patients suffering the massive type had classical pontine hematoma syndrome and fatal outcome, the other three remaining types had atypical or partial clinical features for pontine hemorrhage and survived. It is concluded that CT is highly reliable method for the diagnosis and location of primary pontine hemorrhage.