Citation

Emelifeonwu JA, Reid K, Rhodes JK, Myles L. Brain Inj. 2018; 32(5): 675-677.

Affiliation

Department of Neurosurgery , Western General Hospital , Edinburgh , UK.

Copyright

(Copyright © 2018, Informa - Taylor and Francis Group)

DOI

10.1080/02699052.2018.1429021

PMID

29388863

Abstract

There is good evidence that pupil reactivity is useful for prognostication in acute head injuries. Despite this, most pupil assessments are subjective and are performed by physicians who may not be experts. They can therefore be unreliable. We present a case of a patient with seemingly irreversible demise from an acute traumatic subdural haematoma. This was determined by assessment of his pupils, which were non-reactive to light at the time of arrival to the neurosurgical theatre. He was transferred to the neurointensive care for brainstem death testing, where assessment by objective pupillometry determined that his pupils were in fact reactive. He made a good recovery following subsequent surgery to evacuate his subdural haematoma. We propose the widespread adoption of objective pupillometers in the assessment of acute head-injured patients and offer our case as an example of how an objective and accurate assessment can make a difference to patients' outcome.

Language: en

Keywords

NPi; TBI; Traumatic brain injury; acute subdural haematoma; neuroICU; pupillometer; uncal herniation