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Neurologist versus machine: is the pupillometer better than the naked eye in detecting pupillary reactivity
Christopher L Kramer1, Alejandro A Rabinstein, Eelco F M Wijdicks
1Department of Neurology, Mayo Clinic, Mary Brigh 8-D, 200 First Street SW, Rochester, MN, 55905, USA, kramer.christopher1@mayo.edu.
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 7-9 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.
