Pontine hemorrhage presenting as ataxic hemiparesis.

THE CLINICAL PICTURE of hypertensive pontine hemorrhage is felt to be uniform. Coma is of abrupt onset with pupillary miosis, total external ophthalmoplegia, and quadriplegia. Death is the rule and occurs within hours to days. 2 This picture has been somewhat modified since the advent of CT scanning. Case reports have documented "submassive" pontine hemorrhage with partial to complete recovery. These have included pure motor hemiparesis, quadriplegia with bilateral sixth and seventh nerve palsies with total recovery, and two cases which presented with ocular bobbing with partial recovery. I report a case that presented with ataxic hemiparesis resembling a well known lacunar syndrome.