This case doesn't mesh for me and I am concerned about her. On discharge her pupils were equal and reactive, but should I have pushed more for a head CT based on the assessment? Would the diagnosis have caused a transitory nonreactive pupil with no other change in assessment at that moment? We had her for about 3 hours, and she was still trying to put the johnny as a coat when she left, although she could walk she needed cueing as to where she wanted to go. She also had a UTI, all other labs except tox screen (she had her regular meds in her system) were normal.ĭx was overdose with infection, but no head CT was done. When anisocoria is caused by neurologic disease. With Narcan she was able to stay awake, but still had illogical behavior and appeared sedated. Anisocoria is defined as pupil asymmetry, and may be seen with ocular or neurologic dysfunction (Figure 1). All other vital signs were in the normal range. Interrater agreement among unequal pupils only (n14).
#Unequal pupil size icp manual#
You're maintaining an external ventricular drain. to manual assessment for measurements of pupil size, anisocoria and pupillary light reactivity. Anisocoria results in unequal pupil sizes. If a pulse is heard, further testing is not necessary if not, then ICP needs to be reduced before further evaluation can take place. He plays pretty hard with our other Mini Aussie pup (8 month old black tri) but I have no knowledge of him hitting his head or getting into any bad chemicals. ICP can be measured by using a device called a 'scalp tap.' This involves lightly tapping the back of the head and listening for a pulse at the neck. One pupil was the size of a pin and the other was big. No unilateral weakness or sagging, but on one of my many assessments I found a nonreactive left pupil. Select all the signs and symptoms that occur with increased ICP: A. Unequal pupils by: Holly Last night our 6 month old red merle Mini Aussie with blue eyes had unequal pupils. GCS 14, able to answer simple questions with 1-2 words, but falling asleep. After 24 h, patients pupil became unequal and CT. A woman came into our ER with 2 hours confusion and repeating illogical behavior, like rubbing the top of a countertop over and over again and saying "I need to turn it on." She was 55 years old, on a fair number of meds including Vicodin for back pain that her husband said she didn't take very often, but her didn't know when the last dose was. ICP and ARDS following traumatic brain injury (TBI) with INO.
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