Pontine strokes happen when the blood supply to the pons region of the brainstem is cut off.
It is located above themedulla oblongataand below the cerebral cortex, making it the second-lowest region of the brain.
The pons is responsible for many autonomic nervous system functions.
Illustration by Hilary Allison for Verywell Health
Additionally, theponsis made up of nerves and nerve pathways that send messages between different parts of the brain.
Presentation
The way thestroke presentsitself depends on which blood vessel is blocked.
This is where an individual experiences episodes of stroke-like symptoms that only last for a brief period before resolving.
Remember the acronym FAST:
If you notice these symptoms, seek emergency medical care.
A clot-dissolving drug calledtissue plasminogen activator(tPA)can be an effective treatment for ischemic stroke.
However, it needs to be given within four-and-a-half hours of the onset ofstroke symptomsto work.
Treating a hemorrhagic stroke sometimes can be done with medication and surgery.
In 2018, the American Heart Association and American Stroke Association issued guidelines for stroke treatment.
The guidelines strongly recommend using tPA in patients who are eligible.
However, providers need to evaluate each patient carefully before using the drug.
In hemorrhagic pontine strokes, the 30-day mortality rate is approximately 48.1%.
This number is based on a 2018 systematic review that examined mortality data across several studies.
The level of consciousness at admission and hemorrhage size were the most consistent predictors of mortality.
Larger hemorrhages have a worse prognosis.
Mortality rates for ischemic strokes are more variable and depend on the location of the stroke.
In one 2023 study, the 90-day mortality rate for an ischemic pons stroke was 12%.
Of those who survived, 15 experienced disability, which represented 40% of the cohort.
Patients who have experienced a pontine stroke may also be at risk for an additional stroke.
Recovery
Depending on the extent of the stroke, a pontine stroke may cause several long-term effects.
Some long-term effects include loss of sensation or motor control and difficulties with speech or swallowing.
In severe cases, a person who has had a pontine stroke might need help breathing.
Good nutrition is also essential.
Sensory Reeducation
People who have a loss of sensation after a stroke may benefit from sensory reeducation.
This punch in of therapy uses touch to stimulate sensory processing in the brain.
The goal is to retrain the brain by exposing it to different types of sensory input.
Physical Therapy
Most people recovering from a stroke will need physical therapy.
As you progress with yourphysical therapy treatment, you will do exercises that help improve your balance and coordination.
Speech Therapy
A speech therapist can help you recover your ability to speak clearly after a stroke.
Occupational Therapy
Occupational therapy is similar to physical therapy and involves relearning motor functions.
The goal of occupational therapy is to help you become independent again after a stroke.
Eventually, you will work on more complex tasks like cooking and doing laundry.
Individuals who have experienced a pontine stroke may benefit from mental health services and support groups.
Prevention
Several factors put you at a higher risk of having a stroke.
However, proper management can help reduce the risk of stroke in those with diabetes.
Pons strokes can lead to brain damage.
This punch in of stroke is diagnosed with a neurologic examination and imaging tests.
Some can be treated with a clot-dissolving medication if given soon enough after symptoms begin.
The risk of stroke also increases with age.
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