Stroke and the Pons Region of the Brain

Table of Contents
View All
Table of Contents

The pons is a small region located in the brainstem. It's a relatively small part of the lower brain. And it's sometimes called the hindbrain. The cerebral cortex is the outer layer of the brain. The medulla oblongata is the part of the brain that sends messages to the spinal cord. The pons connects these two structures.

This article discusses stroke and its effect on the pons. It also looks at the symptoms, causes, and risk factors of stroke, as well as diagnosis and treatment. 

 Verywell / Hilary Allison

About the Pons

The pons contains nerves and nerve tracts, also called pathways. These nerves and pathways send messages between different parts of the brain. The pons coordinates a number of important functions, including:

  • Movement
  • Sensory input, such as hearing and taste
  • Balance in the head, neck, and body
  • Eye movement
  • Sleeping
  • Dreaming
  • Digestion
  • Swallowing
  • Breathing
  • Heartbeat

Symptoms of a Pons Stroke

A pons stroke is also called a pontine stroke. Strokes that occur in this part of the brain affect only a small area. Still, they can cause a variety of serious symptoms, including:

A pontine stroke can cause a severe condition called locked-in syndrome. People with locked-in syndrome are awake, alert, and able to think and understand, but can only move their eyes.

Causes of Pons Stroke

There are two types of pons strokes:

An ischemic stroke occurs when a blood clot blocks blood flow through an artery to the brain. A hemorrhagic stroke occurs when a blood vessel breaks, reducing or halting the flow of blood to the brain.

Ischemic and hemorrhagic strokes have the same basic result: Once the blood supply to part of the brain is interrupted, brain cells begin to die. And this causes brain damage. A hemorrhage can also cause damage to nearby brain structures. This is because the bleeding can cause pressure and irritation.

Since the blood vessels that supply blood to the pons and the rest of the brainstem are located in the back of the neck, they could be damaged from a neck injury, sudden pressure, or an abrupt movement of the head or neck. When this happens, a pons stroke may occur.

A stroke affects the physical and cognitive function of the part of the brain where it occurs. Cognitive functions include memory and thought. The extent of the damage depends on the location and size of the stroke.


A pons stroke can be caused by a blood clot or a ruptured blood vessel. Both types reduce or halt blood flow to the brain, causing brain damage.

Risk Factors for Pons Stroke

The risk factors for a pontine stroke are the same as those for strokes in other areas of the brain. They include:

Diagnosis of Pons Stroke

Pontine strokes are diagnosed with a neurologic exam. Some imaging tests can help confirm the diagnosis. These include:

  • Brain magnetic resonance imaging (MRI), a test that uses a magnetic field and radio waves to create images of the brain
  • Brain magnetic resonance angiography (MRA), a test that creates images of the arteries
  • Computerized tomography (CT) angiogram, a test that uses multiple X-ray images to look for blockage in the arteries


Pontine strokes are diagnosed after a neurologic exam. An imaging test can confirm the diagnosis.

Treatment of Pons Stroke

Strokes require immediate medical attention. A clot-dissolving drug called tissue plasminogen activator (tPA) can be an effective treatment for ischemic stroke. To work, it needs to be given within three hours of the onset of stroke symptoms.

Treating a hemorrhagic stroke may involve medication and surgery. The immediate goal is to stop the bleeding, address the cause, relieve symptoms, and prevent complications.

In 2018, the American Heart Association and American Stroke Association issued guidelines for stroke treatment. The guidelines strongly recommend the use of tPA in eligible patients. However, doctors must evaluate each patient carefully before using the drug. Factors that play a role in eligibility include:

In certain patients, tPA can be used up to four-and-a-half hours after the onset of symptoms.

Several treatments can help patients recover from a stroke. They include:

  • Blood thinners
  • Fluid management
  • Treatment of heart problems
  • Good nutrition


A stroke in the pons region of the brain can cause serious symptoms. These may include problems with balance and coordination, double vision, loss of sensation, and weakness in half the body. Pons strokes can be caused by a blood clot or a ruptured blood vessel. Both types can lead to brain damage. People who have certain medical conditions, are inactive, or who smoke or use drugs are at higher risk for any kind of stroke. The risk of stroke also increases with age. Strokes are diagnosed with a neurologic examination and imaging tests. Some can be treated with a clot-dissolving medication if given soon enough after symptoms begin. After a stroke, blood thinners and other therapies can help patients recover.

A Word From Verywell

The faster that you respond to and get emergency treatment for a possible stroke, the better the chances for a robust recovery. This is why healthcare professionals promote the acronym FAST, which ties stroke symptoms to the face, arms, speech, and time to call 911. Ask:

  • Is your face drooping?
  • Can you raise both arms evenly?
  • Are you slurring your words or having trouble speaking?
  • Did you answer yes to any one of these questions? Then it's time to call 911.
Was this page helpful?
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Stroke Association. Brain stem stroke.

  2. Xia C, Chen H, Wu S, Xu W. Etiology of isolated pontine infarctions: a study based on high-resolution MRI and brain small vessel disease scores. BMC Neurol. 2017;17(1):216. doi:10.1186/s12883-017-0999-7.

  3. Khaku AS, Tadi P. Cerebrovascular disease. [Updated 2021 Sep 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:

  4. University of Maryland Medical Center. Hemorrhagic stroke.

  5. Powers WJ, Rabinstein AA, et al. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018;49(3):e46-e110. doi:10.1161/STR.0000000000000158.

  6. Varsou O, Stringer M, Fernandes C, Schwarzbauer C, Macleod M. Stroke recovery and lesion reduction following acute isolated bilateral ischaemic pontine infarction: a case report. BMC Res Notes. 2014;7:728. doi:10.1186/1756-0500-7-728.

  7. Johns Hopkins Medicine. Stroke recovery timeline.

Additional Reading