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CLOT in PONS in CT scan. TREATMENT and precaution.

Resolved Question:

SIR my father have the same problem for 3 days before he fell down and now CT Scan reports show a clot in PONS but after 3 days we repeated a CT Scan shows the same size 2.0 x 2.0 x 1.1 cms noted Iin PONS but my father is eye vision memory both hands and both legs every things working correctly so please Sir Suggest me further treatment and precoution what should be done Thanking u Sir


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Expert:  Dr. Deepu Sebin Sebastian replied 4 Days ago

Hello.
Thank you for your query at DoctorSpring.com.

I understand your concern.
A clot in Pons (Pontine Haemorrhage) results from bleeding in that area, most commonly as a result of high blood pressure, which is a medical emergency. In your case, the size you have mentioned is significant and it should have lead to symptoms such as loss of consciousness, paralysis, visual, hearing and speech disturbances etc. However, you mention that these are all absent.

I would like to have additional information in order to help you better.
1. Please mention your father's age.
2. You have mentioned that he has a problem since 3 days, can you please mention what that is?
3. What was the cause for his fall and how and where did he fall?
4. Due to the fall, did he sustain an injury to his head? Was there any loss of consciousness, headache, vomiting etc after the fall?
5. Does he have any symptoms at all now?
6. Does he have high blood pressure? Any other illness?
7. Please mention the treatment received so far and all the medications he is currently on.
8. Any past history of head injury, loss of consciousness, paralysis etc ?
9. Have you consulted a Neurologist yet?
Please reply to the above questions in the follow-up. Also, please upload the tests he has undergone, including the CT scan for better correlation, in the follow-up.

Awaiting your reply,
Regards.


Patient replied :

Sir my father age is 73 years he is a hypertensive BP patient last 4 days before he fell down with front position small injury to right leg due to high BP 110/210 mm/hg because at that time he has not taken a BP tablet but he is conscious memory is good eye vission is good both hands and leg are working correctly hearing and speaking good no vomitting no head injury no headache, little bit paralysis on face (lips) no past history of head injury right now he has admitted to hospital in ICCU under a Nerologist no bleeding in brain a small clot was noticed in PONS 4 days before and the same CT Scan report came yesterday when repeated a CT Scan So Please sir suggest me the follow up treatment and precaution Thanking u Sir ATHER HUSSAIN S/O KHAJA HUSSAIN


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days ago

Hello. Thank you for the additional information. I have gone through the attached files.
Your father had an episode of bleeding within the brain, specifically within the pons, due to the high blood pressure. This is present as a clot in the pons now.
The good thing is that he does not have any of the expected symptoms such as loss of consciousness, paralysis, visual, hearing and speech disturbances etc.
You need not worry about the size of the clot remaining the same. As long as it is not increasing, there's no need to worry. It usually takes time for it to resolve, from a few weeks to months.
The treatment is lowering the blood pressure and maintaining it in the normal range.
He seems to be receiving the required treatment as he is already in the ICU and under the care of a Neurologist. Please do follow his advice carefully and strictly.
As a long term managment of your father, it is very important that he keeps his BP under strict control, taking his medication regularly.
I hope that addresses your concern. Let me know if I can assist you further.
Regards.


Dr. Deepu Sebin Sebastian
Category: Select Speciality
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
Dr. Deepu Sebin Sebastian and 4 other Medical Specialists are ready to help you

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