A 67-year-old man develops coma over a few minutes. He is unresponsive on arrival to the hospital. He has ataxic respirations and pinpoint, reactive pupils. Oculocephalic reflexes are absent. There is no motor response with noxious stimulation.For the above patient with altered level of consciousness, select the most likely diagnosis.
High-Yield Explanation
Pontine hemorrhage is associated with impaired oculocephalic reflexes and small, reactive pupils. It generally evolves over a few minutes, usually with coma and quadriplegia. The prognosis is poor, and death often occurs within hours.