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Pontine Stroke: Causes, Symptoms, Treatment, and Recovery

medical illustration of brain with pons highlighted within the brain stem to illustrate the location of a pontine stroke

Pontine stroke, also known as pons stroke, is a type of brain stem stroke that often creates chronic side effects.

Understanding the symptoms and treatment for pontine stroke is crucial, because timely treatment can help save a person’s life.

This article will discuss the following facts about pontine stroke: causes, symptoms, treatment, side effects, and rehabilitation.

You can click the above links to jump straight to that section, or dive straight in below.

Causes of Pontine Stroke

Every 40 seconds in the United States, a stroke happens, according to the Centers for Disease Control and Prevention. Unfortunately, this makes it a common health condition.

A stroke occurs when the supply of blood to the brain is compromised by either a clogged artery (called an ischemic stroke) or burst artery (called a hemorrhagic stroke).

illustration of both pontine cerebrovascular accident and hemorrhagic pontine stroke

When stroke happens in the pons, which is the upper section of the brain stem, it’s called a pontine stroke. More formally, an ischemic stroke in the pons is also known as a pontine infarct or pontine cerebrovascular accident.

As the stroke is happening, brain cells begin to die from the deprivation of oxygen-rich blood. Therefore, learning to recognize the symptoms of pontine stroke is essential for reducing death and disability.

Symptoms of Pontine Stroke

When a stroke occurs, it results in the following symptoms that the American Stroke Association summarized in the acronym “FAST”:

  • Facial dropping
  • Arm weakness
  • Slurred speech
  • Time is brain!

Pontine stroke may also have other unique symptoms such as dizziness and vertigo, likely because the pons controls your sense of equilibrium.

A pontine stroke can also result in weakness on both sides of the body, not just one side like most strokes. This can make pontine strokes difficult to diagnose without an MRI scan.

If you ever suspect that someone is having a stroke without typical symptoms, insist that your doctor take an MRI scan. Do not settle for anything less!

Treatment for Pontine Stroke

doctor working with patient on pons stroke treatment

Stroke treatment involves restoring the normal flow of blood in the brain to stop the incident and preserve as much brain tissue as possible.

If the pontine stroke was caused by a blood clot (ischemic stroke), then treatment will involve dissolving the clot to restore blood flow.

A common treatment for ischemic pons stroke (i.e. pontine infarct) is tissue plasminogen activator (tPA), where an injection helps dissolve the clot.

Another treatment option involves an embolectomy, where a stent is surgically inserted into the artery to remove the clot.

Treatment for hemorrhagic pons stroke usually involves surgery to stop the bleeding and restore blood flow.

Timely emergency treatment is essential for reducing death and disability after pontine stroke.

Side Effects of Pontine Stroke

woman recovering in hospital bed after treatment for pontine cerebrovascular accident

Once the pontine stroke has been treated and blood flow has been restored in the brain, the medical team will assess the side effects of the stroke.

When the pons becomes damaged by stroke, it can cause the following side effects:

  • Impaired breathing (and required life support)
  • Loss of consciousness (coma)
  • Locked-in syndrome (the entire body becomes paralyzed except for the eyes)
  • Visual and hearing disturbances
  • Changes in sensation
  • Weakness in the limbs
  • Swallowing and speech difficulty

The larger the stroke was, the more severe the side effects will be. For example, locked-in syndrome is a chronic condition that involves paralysis everywhere except for the eyes.

If a person sustains a massive pontine stroke, the chances are higher for experiencing chronic side effects like this.

Fortunately, some of these side effects can be restored through stroke rehabilitation.

Rehabilitation for Pontine Stroke

Some side effects of pontine stroke can be restored through rehabilitation. Specifically, loss of sensation, weakness in the limbs, and difficulty with speech and swallowing can be improved.

Here are the rehabilitation methods your medical team may use or suggest for recovery:

Sensory Reeducation

woman touching grain for sensory reeducation after pons stroke

When you lose the ability to feel, or when your sensations get all mixed up, sensory reeducation can help you recover.

Sensory reeducation involves retraining the brain to correctly interpret your senses through sensory reeducation exercises, such as touching different textures or temperatures.

Physical Therapy

In order to recover from weakness in the limbs, you need to participate in physical therapy and practice stroke rehabilitation exercises.

The purpose of rehab exercise is to reteach your brain how to control your muscles through massed practice.

Massed practice simply means that a lot of practice will help the brain rewire itself faster. High repetition is key to recovering mobility after stroke.

Want 25 pages of stroke recovery exercises in PDF form? Click here to download our free Stroke Rehab Exercise ebook now (link opens a pop up for uninterrupted reading)

Speech Therapy

speech therapist working with pontine stroke patient

If you struggle with swallowing problems (dysphagia) or speech difficulties (aphasia), you can get help from a Speech-Language Pathologist (SLP).

SLPs will have you practice different exercises to help rewire your brain and improve your control of your mouth, lips, and tongue.

As you can see, stroke rehabilitation revolves around rewiring the brain, and massed practice is very powerful for healing.

Occupational Therapy

Working with an occupational therapist is a great way to improve your proficiency with the Activities of Daily Living.

For instance, occupational therapists are great resources for retraining in self-care skills, such as getting dressed or toileting. They can also offer recommendations for home modifications to help prevent falls, and provide resources for getting back to work or back to driving again.

Essentially, your OT is a great resource for retraining in the activities that help you feel more independent.

Pontine Stroke Recovery Time

As you can see, stroke rehabilitation revolves around rewiring the brain, and massed practice is very powerful for healing.

It’s impossible to estimate your stroke recovery timeline because every stroke is different and therefore each person will take different amounts of time to heal.

There are some general patterns that can help give you an idea of what to expect after a stroke, though.

Typically, if the stroke was small, you can recover within about 6 months. If the stroke was massive, then recovery can take years.

Again, every stroke is different so it’s possible to have a very fast recovery from a massive pontine stroke just as it’s possible to recover slowly from a minor stroke.

Instead of focusing on how long things will take, focus on the steps you can take to maximize recovery, such as massed practice.

Pontine Stroke Recovery

Pontine stroke is a type of brain stem stroke that results in symptoms like dizziness and vertigo. Fast treatment is required to minimize disability and save the person’s life!

After treatment, the medical team will work around the clock to restore and rehabilitate as much function as possible.

Rehabilitation will involve massed practice of the skills and functions that need to be relearned. It’s difficult to estimate how long recovery will take since every stroke is different.

If you or a loved one have suffered a pontine stroke, seeking proper treatment and rehabilitation will maximize outcomes.

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