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181. Horner syndrome due to first rib fracture after major thoracic trauma. (Abstract)

be kept in mind in cases of first rib fractures. When head trauma is considered, as it can be mistaken with anisocoria, this knowledge may help the surgeon in differential diagnosis.

2005 Journal of Pediatric Surgery

182. Adverse effects of apraclonidine used in the diagnosis of Horner syndrome in infants. (Abstract)

Adverse effects of apraclonidine used in the diagnosis of Horner syndrome in infants. Apraclonidine, a selective alpha(2)-agonist, was developed to lower intraocular pressure and minimize the systemic side effects associated with the use of its parent drug, clonidine.(1) An investigation of the site of action of apraclonidine incidentally uncovered a reversal of anisocoria in patients with absent sympathetic innervation of one pupil (Horner syndrome) due to its alpha(1)-effect on a pupil

2007 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

183. Computed tomographic angiography for the diagnosis of blunt carotid/vertebral artery injury: a note of caution. (Abstract)

parallel comparative study aims at validating this high accuracy and examining the rates of evaluability of CTA performed with a 16-detector scanner with image reconstruction by modern imaging software.Patients at risk for BCVI (facial/cervical-spinal fractures; unexplained neurologic deficit; anisocoria; lateral neck soft tissue injury; clinical suspicion) underwent both CTA (16-channel multidetector scanner) and DSA. Results of the 2 studies and the clinical course were prospectively recorded.During

2007 Annals of Surgery

184. The sensitivity and specificity of 0.5% apraclonidine in the diagnosis of oculosympathetic paresis. Full Text available with Trip Pro

hour later.Apraclonidine caused a mean dilation of 2.04 mm (range 1--4.5) (p<0.001) in the pupils with OSP and it caused pupillary constriction in the control eyes with a mean change of -0.14 mm (range 0.5 to --1) (p<0.05). It caused reversal of anisocoria in all HS cases. Its effects on both pupil diameters and upper lid levels differed significantly between the groups (p<0.001). The mean elevation in the upper lid was 1.75 mm (range 1--4) in the OSP group (p<0.001) and 0.61 mm (range 0--3

2005 British Journal of Ophthalmology

185. Efficacy of apraclonidine 0.5% in the diagnosis of Horner syndrome in pediatric patients under low or high illumination. (Abstract)

Efficacy of apraclonidine 0.5% in the diagnosis of Horner syndrome in pediatric patients under low or high illumination. To evaluate the efficacy and safety of apraclonidine 0.5% in the diagnosis of Horner syndrome in pediatric patients.Prospective, interventional case series.Ten pediatric patients with a diagnosis of Horner syndrome and 10 age-matched controls with physiologic anisocoria underwent pharmacological testing with apraclonidine. The difference between the pupil diameters of both (...) ). Three patients with Horner syndrome showed positive values (reversal of anisocoria) only under high ambient illumination, but not under low illumination. There was no statistical difference in the mean differences in pupil diameter before and after apraclonidine testing in the control group. Conjunctival hyperemia was noted in two patients with Horner syndrome and in three patients in the control group. No systemic adverse effects were noted during the examination or were reported by patients

2006 American Journal of Ophthalmology

186. Pupil size in refractive surgery candidates. (Abstract)

Pupil size in refractive surgery candidates. To assess pupil size measurements obtained under scotopic and mesopic conditions with the Procyon pupillometer and under photopic conditions with the Humphrey videokeratographer.The pupil sizes of 96 candidates for refractive surgery (192 eyes) were measured with the Procyon pupillometer PS2000 SA and the Humphrey Atlas 992 corneal topographer. Anisocoria and pupillary unrest were analyzed according to gender (two groups: 51 females and 45 males

2004 Journal of Refractive Surgery

187. Bilateral tonic pupils: Holmes Adie syndrome or generalised neuropathy? Full Text available with Trip Pro

of pupillotonia (small dark diameters, large light diameters, tonic near responses, attenuated light responses with light-near dissociation, and sector palsy). However, significant differences were found in the prevalence and magnitude of several pupil variables in the two patient groups. In particular, sector palsy and anisocoria exceeding 1 mm (in the light) were seen much more commonly in Holmes-Adie patients than patients with generalised neuropathy. The presence of both these pupil signs can be used

2007 British Journal of Ophthalmology

188. Pupillary dilation lag is intermittently present in patients with a stable oculosympathetic defect (Horner syndrome). (Abstract)

Pupillary dilation lag is intermittently present in patients with a stable oculosympathetic defect (Horner syndrome). To examine the repeatability of detecting pupillary dilation lag in patients with Horner syndrome.Retrospective interventional study.Single referral institution.Fifteen patients with unilateral Horner syndrome and 16 subjects with physiologic anisocoria. Intervention procedure: Each subject underwent four pupillometric recordings in darkness. The asymmetry of pupillodilation (...) between the two eyes was calculated as the change in anisocoria between five seconds and 15 seconds in darkness. Pupillary dilation lag was considered present if the asymmetry measured > or =0.4 mm.Asymmetry of pupillodilation over four determinations.All subjects demonstrated fluctuations in the calculated asymmetry of pupillodilation. Eight patients (53%) with Horner syndrome demonstrated dilation lag on the first determination; 13 patients (87%) eventually demonstrated it during four

2007 American Journal of Ophthalmology

189. Risk factors for intraoperative hypotension in traumatic intracranial hematoma. (Abstract)

concerning (1) age; (2) gender; (3) mechanism of injury; (4) Glasgow Coma Scale (GCS) on admission; (5) abnormality of the pupils (anisocoria or mydriasis); (6) mean arterial blood pressure; (7) heart rate; (8) time elapsed before craniotomy from injury; (9) initial brain CT scans; (10) duration of craniotomy; and (11) total infusion or urine volume until craniotomy were collected prospectively as IHT risk factors. Low GCS score (<5), tachycardia (heart rate >112min(-1)) and hypertension (mean blood

2004 Resuscitation

190. Bilateral posterior dislocation of the crystalline lens after a head injury sustained during a seizure. Full Text available with Trip Pro

Bilateral posterior dislocation of the crystalline lens after a head injury sustained during a seizure. This article presents a case of bilateral posterior dislocations of the crystalline lens in a patient with epilepsy who presented with reduced vision and anisocoria 2 weeks after having sustained head injuries during a seizure. The possibility of lens dislocation was raised only at this time, and subsequently confirmed on computed tomography. Such patients may require prompt referral

2007 Emergency Medicine Journal

191. Pupillary Abnormalities

flashlight test, whereas the normal eye will both constrict normally and show a normal consensual response. It can be hard to perform the test accurately. Examiner bias, light position variability, and difficulty observing both eyes, dark irises, pre-existing anisocoria, small pupils and the presence of efferent defects may make it difficult to detect asymmetry. In glaucoma an RAPD indicates that there is more optic nerve damage in one eye than in the other, even if the visual acuity in both eyes (...) ) to their near point (about an arm's length away) and observe the pupillary reflex when their fixation shifts to the near target. A normal test shows a brisk constriction. In near-light dissociation, the patient has a better pupillary near reflex than light reflex. Pupillary abnormalities [ ] Pupillary disorders may involve the afferent pathways (RAPD) or the efferent pathways. Anisocoria, where not physiological, indicates a problem of the efferent pupillary pathway, either parasympathetic or sympathetic

2008 Mentor

192. Horner's Syndrome

. You may find one of our more useful. In this article In This Article Horner's Syndrome In this article Synonym: Bernard-Horner syndrome (commonly used in France); oculosympathetic paresis This is a rare condition that results from disruption of the sympathetic nerves supplying the eye. There is the triad of: Partial ptosis (upper eyelid drooping). Miosis (pupillary constriction) leading to anisocoria (difference in size of the pupils). Hemifacial anhidrosis (absence of sweating). Neuroanatomy

2008 Mentor

193. Examination of the Cranial Nerves

and possibly a ptosis too. Horner's syndrome is a very good lateralising sign but a poor localising sign. The Argyll Robertson's pupil is small, does not react to light, but constricts on accommodation. If it is bilateral, the pupils are frequently unequal in size (anisocoria). Argyll Robertson's pupils are almost always related to neurosyphilis but similar pupils are occasionally found in diabetic neuropathy and in some hereditary neuropathies. The myotonic pupil (Holmes-Adie syndrome) reacts very slowly

2008 Mentor

194. Examination of the Eye

passing through the shaft of light) and for flare (slight cloudiness), suggestive of anterior . Pupils Look at their relative size - if you suspect anisocoria (different-sized pupils), stand back from the patient, darken the room and look through the ophthalmoscope. You can elicit the red reflex in both eyes and compare the size of these directly rather than shifting from one to the other close up. Look for change in shape (typically oval in acute angle-closure glaucoma, asymmetry in a penetrating

2008 Mentor

195. A case of Brown-Sequard syndrome with associated Horner's syndrome after blunt injury to the cervical spine Full Text available with Trip Pro

. Neurological examination however, revealed anisocoria, his left pupil being smaller than his right, and a Brown-Sequard syndrome, with a sensory level at C6. Immobilisation was maintained and he was transferred to the regional neurosurgical centre where magnetic resonance imaging revealed a contusion of the left half of the spinal cord adjacent to the 6th cervical vertebrae. Computed tomography revealed no bony injury but spinal column instability was demonstrated after flexion-extension spinal views

2001 Emergency Medicine Journal : EMJ

196. Dissociated unilateral convergence paralysis in a patient with thalamotectal haemorrhage. Full Text available with Trip Pro

Dissociated unilateral convergence paralysis in a patient with thalamotectal haemorrhage. A 47 year old male was admitted in a comatose state. CT scan showed a haemorrhage in the right pulvinar thalamus descending into the right part of the lamina quadrigemina. He presented with anisocoria, prompt bilateral pupillary light reaction, and unilateral convergence paralysis contralateral to the lesion in combination with upward gaze palsy. During an observation period of two months, the convergence

1992 Journal of neurology, neurosurgery, and psychiatry

197. Naloxone eye drops reverse the miosis in runners--implications for an endogenous opiate test. (Abstract)

that exercise generated endogenous opiates cause pupillary miosis, and that ophthalmic naloxone to one eye can block this exercise pupillary effect resulting in ipsilateral mydriasis. Suggestions are given for a simple "Naloxone Anisocoria Test" for the presence or absence of elevated endogenous opiates.

1983 Canadian journal of applied sport sciences. Journal canadien des sciences appliquées au sport

198. Pupillary response to tropicamide in patients with Alzheimer disease. (Abstract)

and area of both eyes were measured in light and darkness, at 10-minute intervals for 40 minutes after random instillation of 0.01% tropicamide to one eye. Four groups of subjects were studied: 9 patients with AD, 10 who were treated with tacrine, 11 older control subjects, and 10 young control subjects.Mean change in anisocoria was not significantly different among groups at any of the measurement time points. Mean percent change in diameter of the treated eyes showed a trend toward faster maximum

1996 Ophthalmology Controlled trial quality: uncertain

199. Unequal pupil size in patients with unilateral red eye. Full Text available with Trip Pro

Unequal pupil size in patients with unilateral red eye. 2021723 1991 06 03 2018 11 13 0959-8138 302 6776 1991 Mar 09 BMJ (Clinical research ed.) BMJ Unequal pupil size in patients with unilateral red eye. 571-2 Rose G E GE Moorfields Eye Hospital, London. Pearson R V RV eng Journal Article England BMJ 8900488 0959-8138 AIM IM Adult Anisocoria pathology Color Eye pathology Eye Diseases diagnosis pathology Female Humans Incidence Male 1991 3 9 1991 3 9 0 1 1991 3 9 0 0 ppublish 2021723 PMC1669415

1991 BMJ : British Medical Journal

200. Pituitary carcinoma in an Airedale terrier Full Text available with Trip Pro

Pituitary carcinoma in an Airedale terrier A 6-year-old Airdale terrier showed behavioral changes for 1 mo, progressing to neurological signs that included proprioceptive deficits, circling, anisocoria, and head pressing. A large, invasive, pituitary carcinoma was diagnosed at postmortem.

2003 The Canadian Veterinary Journal

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