A 67-year-old man develops coma over a few minutes. He is unresponsive on arrival to the hospital. He has ataxic respirations and pin-point, 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.