From the Guidelines
A left pontine stroke typically presents with a distinct set of symptoms, including right-sided weakness or paralysis, sensory deficits, speech difficulties, ataxia, and cranial nerve abnormalities, as a result of damage to the critical brainstem area. The symptoms of a left pontine stroke can vary but commonly include sudden numbness or weakness of the face, arm, or leg, especially on one side of the body, sudden confusion, trouble speaking or understanding, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance or coordination, and sudden severe headache with no known cause 1. Patients may experience right-sided hemiparesis or hemiplegia, affecting both the face and limbs, due to the crossing of motor pathways before reaching the pons.
Some key symptoms to look out for include:
- Right-sided weakness or paralysis
- Sensory deficits on the right side of the body
- Speech difficulties, such as dysarthria
- Ataxia and difficulty walking
- Cranial nerve abnormalities, including diplopia, facial numbness, and problems with eye movements
- Vertigo, nausea, and vomiting
- Altered consciousness or breathing difficulties in severe cases
It is essential to recognize these symptoms early and activate the emergency medical services (EMS) system promptly, as timely intervention can significantly improve outcomes in patients with acute ischemic stroke 1. Early detection and prompt treatment are critical in limiting neurological injury and improving the quality of life for patients with a left pontine stroke.
From the Research
Symptoms of Left Pontine Stroke
The symptoms of a left pontine stroke can vary depending on the location and extent of the damage. Some common symptoms include:
- Dysarthria (difficulty speaking) 2, 3, 4
- Dysphagia (difficulty swallowing) 2
- Hemiparesis (weakness on one side of the body) 2, 3, 4
- Ataxia (loss of coordination and balance) 3
- Sensory deficits (numbness or tingling) 3, 4
- Eye movement disorders 3, 4
- Vertigo and dizziness 3
- Pathological laughing 4
Clinical Patterns of Pontine Infarction
Studies have identified several clinical patterns of pontine infarction, including:
- Anteromedial pontine syndrome: characterized by motor deficit, dysarthria, ataxia, and mild tegmental signs 3
- Anterolateral pontine syndrome: characterized by motor and sensory deficits, and tegmental signs 3
- Tegmental pontine syndrome: characterized by mild motor deficits, sensory syndromes, eye movement disorders, and vestibular system symptoms 3
- Bilateral pontine syndrome: characterized by transient consciousness loss, tetraparesis, and acute pseudobulbar palsy 3
- Unilateral multiple pontine infarcts: characterized by severe sensory-motor deficits and tegmental signs 3
Prognosis and Outcome
The prognosis and outcome of a left pontine stroke can vary depending on the location and extent of the damage. Studies have shown that patients with upper pontine lesions tend to have better outcomes than those with lower pontine lesions 4. Additionally, the presence of basilar artery branch disease (BABD) and small-artery disease (SAD) are common causes of stroke in patients with pontine infarction 3.