Unequal pupil size bipolar full#

Unequal pupil size bipolar full#

Determining the cause of anisocoria can be challenging in critical care settings because patients often are sedated, paralysed, intubated, or have a baseline altered mental status that makes full neurologic examination difficult. Benign mydriasis can be due to prior trauma, medication effects, and congenital abnormalities. Right pupil was both normal in size and in responsiveness to light, and her left pupil was fully dilated after nebulised albuterol (salbutamol) and ipratropium bromide through a face maskДЄnisocoria, or unequal pupil size, may be an early sign of an impending neurologic emergency in any patient and often suggestive of a life threatening condition affecting cranial nerve function, such as tumour compression, intracranial hypertension with impending uncal herniation, expanding intracranial aneurysm, or haemorrhage. The anisocoria resolved within 24 hours after the patient stopped receiving ipratropium. The face mask was found to fit imperfectly and leak slightly to the left. Further, review disclosed that she received oxygen and nebulised albuterol (salbutamol) and ipratropium bromide through a face mask. A computed tomographic scan of her head, performed to search for an intracranial cause of partial palsy of the third cranial nerve, was normal.

Examination of the cranial nerves showed no other abnormalities. After 12 hours from admission, her nurse noticed that, her right pupil was both normal in size and in responsiveness to light, and her left pupil was fully dilated. Anisocoria (a unilateral dilated pupil) in critical care patients is a point of concern, which warrants a thorough examination and often, also, costly investigations to rule out a serious cause.ДЄ 48-year-old female patient transferred to our intensive care for further management of respiratory failure due to fungal pneumonia.