This makes the pupil size and the pupillary light reflex an important factor to be considered in many clinical conditions as described, for example, in the work of Loewenfeld. Keywords: Intracranial pressure, Neurological Pupil index, pupillometer, traumatic brain injuryĭifferent neuroanatomical pathways are involved in the control of the pupil, and the integrity and functionality of these neurological pathways can often be ascertained through the analysis and interpretation of pupillary behavior. Quantitative measurement and classification of pupillary reactivity using NPi may be a useful tool in the early management of patients with causes of increased ICP.
Using NPi, we were able to identify a trend of inverse relationship between decreasing pupil reactivity and increasing ICP. In the group of patients with abnormal pupillary reactivity, we found that the first evidence of pupil abnormality occurred, on average, 15.9 hours prior to the time of the peak of ICP.ĬonclusionsAutomated pupillary assessment was used in patients with possible increased ICP. Patients with “nonreactive pupils” had the highest peaks of ICP (mean = 33.8 mmHg, P = 0.0046). ResultsPatients with abnormal pupillary light reactivity had an average peak ICP of 30.5 mmHg versus 19.6 mmHg for the normal pupil reactivity population ( P = 0.0014).
#Unequal pupil size head injury portable
Pupillary examination was performed using a portable hand-held pupillometer. Methods134 patients (mean age 46 years, range 18–87 years, 54 women and 80 men) in the intensive care units at eight different clinical sites were enrolled in the study. This may occur in patients with severe traumatic brain injury (TBI), aneurysmal subarachnoid hemorrhage, or intracerebral hemorrhage (ICH). BackgroundThis paper introduces the al Pupil index (NPi), a sensitive measure of pupil reactivity and an early indicator of increasing intracranial pressure (ICP).
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