{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T15:10:08Z","timestamp":1784214608178,"version":"3.55.0"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":172,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Neurological Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Bell\u2019s palsy, the most common cause of idiopathic peripheral facial palsy, is typically attributed to viral reactivation; however, rare cases due to cerebrovascular disease must always be considered in the differential diagnosis. We report the case of a 75\u2010year\u2010old man with poorly controlled hypertension, diabetes mellitus, and a history of smoking who presented with progressive left\u2010sided facial paralysis over four days. Initially suspected to have Bell\u2019s palsy due to the lower motor neuron pattern and gradual onset, further neuroimaging revealed a different etiology. T2\n                    <jats:sup>\u2217<\/jats:sup>\n                    \u2010weighted MRI showed a low\u2010signal area in the left pons, and a noncontrast CT confirmed a small hemorrhage. This atypical presentation, characterized by a gradual onset and absence of additional neurological symptoms, was attributed to focal compression of the facial nerve by the hematoma. The patient was treated conservatively with hemostatic agents, bed rest, and rehabilitation, leading to symptomatic improvement. His symptoms began to improve by the fourth day of hospitalization, and follow\u2010up imaging showed no hematoma expansion, with signs of absorption by Day 7. He was discharged after 15\u2009days. This case highlights the diagnostic challenge in distinguishing Bell\u2019s palsy from facial peripheral paralysis secondary to brainstem cerebrovascular events, particularly in patients with vascular risk factors. It underscores the importance of a \u201cselective imaging strategy,\u201d emphasizing that neuroimaging should be strongly considered in atypical or progressive cases, even when classic signs of a stroke are absent.\n                  <\/jats:p>","DOI":"10.1155\/crnm\/2754979","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T09:59:57Z","timestamp":1782122397000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pontine Hemorrhage Mimicking Bell\u2019s Palsy: Isolated Facial Nerve Palsy\u2014A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"given":"Rei","family":"Takeichi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3037-169X","authenticated-orcid":false,"given":"Nobukazu","family":"Miyamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3326-8559","authenticated-orcid":false,"given":"Haruka","family":"Takeshige-Amano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2009-2486","authenticated-orcid":false,"given":"Wataru","family":"Sako","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2034-2556","authenticated-orcid":false,"given":"Nobutaka","family":"Hattori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-309563"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.71.2.149"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24496"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/003591576706011p145"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.46.1.165"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/pn-2023-003839"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.11.118"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-019-1440-1"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002142-199606000-00003"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2017-223214"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics15172135"}],"container-title":["Case Reports in Neurological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crnm\/2754979","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crnm\/2754979","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crnm\/2754979","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T14:50:40Z","timestamp":1784213440000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crnm\/2754979"}},"subtitle":[],"editor":[{"given":"Semonti","family":"Nandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crnm\/2754979"],"URL":"https:\/\/doi.org\/10.1155\/crnm\/2754979","archive":["Portico"],"relation":{},"ISSN":["2090-6668","2090-6676"],"issn-type":[{"value":"2090-6668","type":"print"},{"value":"2090-6676","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-06-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"2754979"}}