The pons is the bulging middle part of the brainstem, named after the Latin word for bridge because its large front portion carries fibres crossing to the cerebellum. Its front part (basilar pons) relays signals from the cerebral cortex to the cerebellum, while its back part (tegmentum) contains cranial nerve nuclei V to VIII and centres for breathing, sleep and eye movement.
| Location | Between the midbrain above and the medulla below, in front of the cerebellum and fourth ventricle, resting on the clivus |
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| Parts |
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| Connections |
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| Blood Supply | Basilar artery (paramedian, short and long circumferential pontine branches); Anterior inferior cerebellar artery; Superior cerebellar artery |
Relays cortical motor plans to the cerebellum, controls facial movement and sensation, horizontal gaze and hearing and balance pathways, and helps regulate breathing rhythm and REM sleep.
A large stroke of the basilar pons causes locked-in syndrome. Rapid correction of low blood sodium can cause osmotic demyelination (central pontine myelinolysis). Lesions of the pontine tegmentum produce horizontal gaze palsies, internuclear ophthalmoplegia or the one-and-a-half syndrome, and pinpoint pupils are a classic sign of pontine haemorrhage.
Ventral pontine infarction, usually from basilar artery occlusion, causing complete paralysis with preserved consciousness and vertical eye movements.
Demyelination of the central pons and sometimes other areas after too-rapid correction of chronic hyponatraemia, causing quadriparesis and swallowing difficulty.
Hypertensive bleeding in the pons causing sudden coma, pinpoint pupils, quadriplegia and often death.
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