Twenty-Four Syndrome: An Untold Presentation of Pontine Hemorrhage

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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.

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