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

Abstract 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.

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Publication Details

Journal
Stroke Clinician
Published
2025-09-12
DOI
https://doi.org/10.59236/sc.v2i3.92
Primary Topic
Vascular Malformations Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
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article

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

Thomas Varkey, Kartik Akkihal, J Zhang, Holly Yancy
Stroke Clinician
Vascular Malformations Diagnosis and Treatment
article

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

Thomas Varkey, Kartik Akkihal, J Zhang, Holly Yancy
article en

Abstract

Abstract 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.

Stroke Clinician
University of Arizona (US), University of Phoenix (US), Texas College (US), Texas A&M University (US)
Openalex Percentile: Top 64%
Vascular Malformations Diagnosis and Treatment
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Malicious Veins: Intraparenchymal hemorrhage in the pons secondary to a cavernous malformation - a case report — Thomas Varkey, Kartik Akkihal, et al. · Stroke Clinician (2025) | TGRS Research Map | TGRS