GROSS PONTILE BLEEDING IN TRAUMATIC AND NONTRAUMATIC CEREBRAL LESIONS

The discovery of a pontile hemorrhage in addition to subdural and cerebral hemorrhages in a case of head trauma, prompted us to investigate the pons in other cases of this sort coming to necropsy. We also paid particular attention to the pons in cerebral vascular disease, abscess and tumor, and were surprised to find that pontile bleeding is not uncommon in them and in traumatic lesions. The importance of pontile hemorrhage, especially in traumatic cases, can be readily appreciated because it vitiates, in part, signs and symptoms which ordinarily might be of significant localizing value and might thus lead to operation. Conjugate deviation of the eyes and head, often considered a cerebral sign, might be produced by the pontile lesion and so give rise to an erroneous localization diagnosis. The frequent absence of cranial nerve paralysis in pontile hemorrhage may be misleading, and is explained by the fact that the