Twenty-Four Syndrome: An Untold Presentation of Pontine Hemorrhage

Abstract

Pontine hemorrhages are relatively uncommon. Various atypical manifestations of pontine stroke like eight-and-a-half syndrome, fifteen-and-a-half syndrome, and sixteen syndrome have been described in the past. We came across a case of pontine bleed that presented with bilateral facial palsy, bilateral horizontal gaze palsy, and contralateral sensorineural hearing loss accounting to the hitherto not described "twenty-four syndrome" with Horner's syndrome and left hemiparesis.

Keywords: Pontine hemorrhage; bilateral horizontal gaze palsy; contralateral sensorineural hearing loss; facial diplegia.