A pontine stroke is a stroke that develops in the blood vessels that supply your pons, a structure in the brainstem that controls unconscious functions like the sleep-wake cycle and coordinating movements.

A stroke occurs when the blood supply in your brain becomes blocked or when a blood vessel in your brain bursts.

A pontine stroke occurs in the blood vessels inside a structure in your brainstem called your pons. This part of your brain controls many essential processes, like your breathing and balance.

Pontine strokes can cause many different symptoms, such as paralysis or trouble coordinating movement. Symptoms may improve over time depending on the extent of your stroke and how soon you receive treatment.

Read on to learn more about pontine strokes, including their symptoms, treatment, and outlook.

Although pontine strokes are common, they often occur alongside strokes in other parts of your brain. Initial signs of stroke can include sudden:

  • numbness or weakness in your face and limbs
  • confusion
  • trouble seeing
  • trouble walking
  • headache

Specific Pontine stroke specific symptoms

The symptoms of a pontine stroke depend on which part of your pons is affected. Some of the more common symptom patterns include the following.

Ventro-caudal pontine infarction

A ventro-caudal pontine infarction is characterized by:

  • partial or complete paralysis on the opposite side of your body as your stroke
  • weakness on your opposite side
  • decreased pain and temperature sensation on your opposite side
  • inward turn of eye (abducens palsy) on the same side
  • facial paralysis on the same side

Mid-pontine base infarction

Mid-pontine base infarction might cause:

  • loss of coordination on the same side
  • weakness and loss of sensation on the same side of your face
  • paralysis on the opposite side of your body

Tegmental pontine syndrome

Tegmental pontine syndrome can cause:

  • loss of face sensation on the same side
  • paralysis of your muscles on the same side
  • impaired blinking on the same side
  • loss of coordination on the same side
  • sensory loss on the opposite side of your body

Multiple pontine infarcts

Multiple pontine infarcts can cause pseudobulbar palsy, which is the inability to control the muscles in your face. It may also cause:

  • trouble controlling emotions like sudden laughing or crying
  • spasms in your vocal cords
  • difficult swallowing
  • slowed or slurred speech

Bilateral pontine infarcts

If the blockage occurs in your basilar artery that runs down the middle of your pons, you might have symptoms on both sides of your body. Large blockages can cause:

  • paralysis in both arms and legs
  • facial paralysis on both sides
  • trouble with the muscles that control swallowing and breathing
  • trouble speaking

Pontine strokes are caused by blockages or ruptures in the blood vessels in your pons. Blockages can be caused by blood clots or other substances moving through your bloodstream.

Pontine strokes make up about 10% of strokes. It’s the most common stroke subtype in the rear part of your brain.

About 10–33% of people have pontine strokes that affect both sides.

The risk of pontine stroke increases with age, and they’re most common in adults over 65 with a history of:

Diabetes seems to be more common in people who develop pontine strokes than strokes in the front part of the brain. In a 2022 study, researchers also found evidence that diabetes is more common in people with pontine strokes than strokes in other parts of the rear brain.

A stroke can be life threatening. Survivors often have permanent or temporary complications, such as:

Medical emergency

It’s critical to get immediate emergency medical attention. Call emergency medical services or have someone take you to the nearest emergency room if you have signs of a stroke, such as sudden:

  • numbness or weakness
  • facial drooping
  • confusion, trouble speaking, or difficulty understanding speech
  • trouble seeing
  • trouble walking
  • dizziness

Doctors can use imaging like computed tomography (CT) scans or magnetic resonance imaging to see the location of your stroke. To rule out other conditions you may receive:

Initial stroke treatment involves emergency medical attention to stop the bleeding or blockage and prevent complications.

You may receive a procedure called mechanical thrombectomy to remove a blockage from your blood vessel. You may also receive medications to help break up blood clots. The most commonly used medication is intravenous altepase, administered within 4.5 hours of symptom onset.

Your doctor may recommend therapies to help your recovery, such as:

In a 2018 study, researchers found that stroke size was the most influential factor in determining the chances of survival for people who had a pontine stroke. In a 2018 review of studies, researchers reported a 30-day mortality rate of 48.1%.

In a 2022 study, researchers found that the reoccurrence rate of pontine strokes were:

  • 4.1% at 1 month
  • 6.3% at 6 months
  • 7.8% at 1 year

Some ways that you can prevent a stroke include:

Speak with a doctor about taking baby aspirin or cholesterol medications like statins. These may help lower your risk of stroke.

If you have a history of blood clots or a disease that increases your risk of blood clots, you may benefit from blood thinners to prevent clots that could lead to strokes

Learn more about stroke prevention.

Here are some frequently asked questions people have about pontine strokes.

What are the symptoms of pons damage?

Damage to your pons can cause many symptoms, including difficulty with speech or swallowing, paralysis, or loss of coordination.

What is the survival rate of pontine stroke?

In a 2018 review of studies, researchers reported a mortality rate of 48.1% within about 30 days of pontine stroke.

Can you fully recover from a pons stroke?

Some people may make a full recovery from a pontine stroke, but other people may have permanent physical or cognitive symptoms. You may continue to have improvements in your symptoms for years after your stroke.

What are the deficits of a pontine stroke?

A deficit is a long-term complication of a stroke. After a pontine stroke, some people have motor or sensory deficits, meaning problems with movement and sensation, respectively.

People who develop a pontine stroke can develop symptoms such as paralysis, loss of sensation, and loss of coordination. Immediate treatment can help reduce long-term complications.