Malicious Veins: Intraparenchymal hemorrhage in the pons secondary to a cavernous malformation - a case report

Introduction: Hemorrhagic stroke, especially in the brainstem can be highly disabling and life threating. In all cases, the cause of said stroke must be addressed to prevent further life threating conditions or worsening. Case Presentation: Herein, the authors present a diagnostic dilemma case in which a young patient had a hemorrhage within the pons and the steps taken to best treat the patient and prevent injury and death while also evaluating for cause of the neurologic injury. Discussion/Conclusion: Special attention is drawn to the use of hypertonic agents and the root cause of abnormal vasculature within the intracranial space. Patients’ presentation can often minimize the actual level of injury when presenting with aberrant neurovasculature. Imaging including Magnetic Resonance Imaging and Computerized Tomography can better help with determining the cause of symptoms. Hypertonic agents are a controversial treatment, therefore, considering the risks and benefits to the patient, these can and should be utilized to ensure protection of life.