Lateral pontine hemorrhage: atypical clinical manifestations and good outcome

Two hypertensive patients presented clinically with unilateral hematomas of the basis pontis demonstrated by computed tomography (CT) scan. Clinical signs showed hemiparesis while the typical signs of pontine hemorrhage--including coma, pin point pupils, ocular bobbing, respiratory abnormalities, and hyperthermia--were absent. Both patients survived with good recovery. Our observations suggest that some patients with pontine hemorrhage produce atypical clinical manifestations and have a good prognosis. Accurate diagnosis may be difficult without CT scan in such cases.