Neurologist Versus Machine: Is the Pupillometer Better than the Naked Eye in Detecting Pupillary Reactivity

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• 作者：Christopher L. Kramer ; Alejandro A. Rabinstein ; Eelco F. M. Wijdicks…
• 关键词：Pupillometer ; Neurological examination ; Brain death ; Uncal herniation ; Neurocritical care ; Pupillary reactivity
• 刊名：Neurocritical Care
• 出版年：2014
• 出版时间：October 2014
• 年：2014
• 卷：21
• 期：2
• 页码：309-311
• 全文大小：287 KB
• 参考文献：1. Walters BC et al. Early indicators of prognosis in severe traumatic brain injury. Brain Trauma Foundation Guidelines 2000; 186-98.
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• 作者单位：Christopher L. Kramer (1)
  Alejandro A. Rabinstein (1)
  Eelco F. M. Wijdicks (1)
  Sara E. Hocker (1)
  
  1. Department of Neurology, Mayo Clinic, Mary Brigh 8-D, 200 First Street SW, Rochester, MN, 55905, USA
  
• ISSN：1556-0961

文摘

Background A 62-year-old man with severe traumatic brain injury developed postsurgical anisocoria in which there was a discrepancy between pupillometer and manual testing. Methods Case report. Results The patient’s larger pupil was read as unreactive by the pupillometer but constricted 1?mm over 7-?s of continuous light stimulation. Conclusions While pupillometry assessment is a valuable adjunct to the manual pupillary assessment, this case demonstrates that nonreactive pupils read on the pupillometer should be confirmed with the manual examination because it can miss very slowly reacting pupils.