The ascending reticular activating system (ARAS) is known to play an essential role in maintaining arousal and consciousness. In this report. we describe the case of a patient with impaired consciousness due to injury of the ARAS after bilateral pontine infarction. A 73-year-old female patient presented with anterior chest pain to the Emergency Department of our university hospital. https://www.roneverhart.com/Dean-Guitars-Michael-Amott-Tyrant-X-Splatter-Electric-Guitar-p19869/