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Updated: Jul 10, 2026
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Ultrasound Cyclo Plasty in Eyes with Glaucoma
Published on: January 26, 2018
Unilateral fixed dilated pupil during plastic surgery--a case report.
Sheng-Hua Wu1, Shu-Hung Huang, I-Chen Lu
1Departments of Anesthesiology, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
Summary
A patient with head trauma experienced a dilated pupil during surgery, raising concerns of bleeding. However, imaging confirmed no worsening intracranial hemorrhage, and the pupil normalized post-anesthesia.
Area of Science:
- Anesthesiology
- Neurosurgery
- Trauma Care
Background:
- A 34-year-old male with multiple trauma, including mild intracranial hemorrhage and facial/thigh fractures, underwent surgical repair.
- Anesthesia involved fentanyl, thiamylal, rocuronium, and sevoflurane. Epinephrine was used for nasal mucosal infiltration during facial bone fixation.
Observation:
- During facial bone repair, the patient developed a fully dilated left pupil unresponsive to light.
- This finding raised immediate concern for exacerbation of intracranial hemorrhage.
Findings:
- An urgent CT scan revealed no progression of the intracranial hemorrhage compared to preoperative imaging.
- The patient recovered uneventfully from anesthesia, and the left pupil returned to normal.
Implications:
- Transient pupillary changes during surgery in trauma patients may not always indicate worsening intracranial pathology.
- Careful monitoring and prompt neuroimaging are crucial in managing trauma patients with neurological signs during procedures.
- This case highlights the importance of considering anesthetic agents and surgical interventions as potential causes of neurological signs.
