Lateral pontine hemorrhage: reappraisal of benign cases

We reviewed 6 computed tomography-documented cases of primary lateral pontine hemorrhage that occurred in our two institutions over a 2-year period. All patients survived the acute stroke, with excellent functional recovery in 4. The level of consciousness of the patient and the size of the hemorrhage had no consistent bearing on outcome. Both of these features have been considered important prognostic indicators in patients with pontine hemorrhage, but in our series benign outcomes were not restricted only to patients who were alert or had small hemorrhages; on the other hand, severe disability was noticed in 1 patient with a small hematoma strategically located in the pontine tegmentum. Our observations suggest that, although some patients with lateral pontine hemorrhage have a good prognosis, there is no single determinant that predicts outcome in a given patient.