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61. Reverse Locked-In Syndrome Full Text available with Trip Pro

pupillary and oculomotor paralysis. MRI revealed infarction of the bilateral oculomotor nuclei in the midbrain tegmentum. At 9-month follow-up, he had anisocoria and dysconjugate gaze, but was living at home and required minimal assistance in performing all activities of daily living.Since the patient's deficits were the exact opposite of those described in locked-in syndrome, we propose the term "reverse locked-in syndrome" to describe this neurological entity characterized by bilateral ptosis, non

2017 Neurocritical care

62. The PUPIL Study

pathway. The SFM is a qualitative test, and relies upon visualising no pupillary constriction or immediate or delayed pupillary dilation; if either of these responses is observed, an RAPD is believed to be present. The SFM requires a trained examiner and many potential sources of error may confound the results, including anisocoria, off-axis pupil illumination, and unequal retinal bleaching. Pupil abnormalities may be subtle and easily missed using the SFM. Automated pupilometers allow examiners

2017 Clinical Trials

63. Intracranial pressure in patients undergoing decompressive craniectomy: new perspective on thresholds. Full Text available with Trip Pro

and analyzed. From these findings, ICP thresholds discriminating favorable from unfavorable outcome were calculated using conditional inference tree analysis. Additionally, survival analysis was performed using the Kaplan-Meier method. Prognostic factors were assessed via univariate analysis and multivariate logistic regression. Favorable outcome was defined as a score of 0-4 on the modified Rankin Scale. RESULTS Multivariate logistic regression revealed that anisocoria, diagnosis, and ICP values differed

2017 Journal of Neurosurgery

64. Munchausen by proxy syndrome mimicking systemic autoinflammatory disease: case report and review of the literature. Full Text available with Trip Pro

infections and reversible anisocoria in the absence of laboratory evidence of systemic inflammation. After two and a half years of extensive diagnostic work-up and multiple empirical therapies, a final diagnosis of Munchausen by proxy syndrome (MBPS) was established.The diagnosis of SAID needs to be carefully reassessed if measurable systemic inflammation is missing, and MBPS should be included in the differential diagnosis.

2017 Pediatric Rheumatology

65. Dental local anaesthesia and ophthalmic side effects

Diplopia Endophthalmitis Globe penetration Horner syndrome Impaired visual acuity (blurred vision) Strabismus (convergent or divergent) Loss of accommodation (cycloplegia) Mydriasis (dilation of the pupil) Ophthalmoplegia (internal or external, partial or total) Ptosis 92% were transient – of these 25% took 6 hours to resolve. 8% caused permanent functional damage, either as vision deficit or anisocoria (two pupils are not of equal size). 46 were reported with maxillary injections, 42 with mandibular

2016 The Dental Elf

66. 2017 PEMPix Online Case #2: Big Circle

on the ipsilateral side and resting left sided esotropia Partial palsy of CN 3 resulted in ptosis and anisocoria Additionally, the patient was bradycardic on presentation, which was likely due to the oculocardiac reflex. A decreased pulse rate occurs when traction is applied to the extra-ocular muscles or when the eyeball is compressed, and is mediated by nervous fibers that connect the cranial nerves with the vagus and parasympathetic nervous system. His CT scan revealed a well circumscribed, hyperdense mass

2017 PEM Blog

67. Tonic pupil after botulinum toxin-A injection for treatment of esotropia in children. Full Text available with Trip Pro

3 cases occurred in the left eye of participants who underwent bilateral BTX-A injection by the same surgeon. Anisocoria diminished from a maximum of 4 mm at the 2-week visit to 1-2 mm in all patients over the 9-month postinjection data collection period. No adverse visual outcomes were noted. Tonic pupil is an infrequently reported complication of BTX-A injection for strabismus. The experience of our investigator group suggests the need for careful injection technique and thorough preinjection

2016 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

68. Underestimation of Pupil Size by Critical Care and Neurosurgical Nurses. Full Text available with Trip Pro

of critical care and neurosurgical nurses' assessments of pupils was determined. The study included assessment of drawings of eyes with an iris and pupil, examination of photographs of human eyes, and bedside examination of patients with a head injury.Subjective assessments of pupil diameter and symmetry were not accurate. Across all phases of the study, pupil diameters were underestimated and the rate of error increased as pupil size increased. Nurses also failed to detect anisocoria and misidentified (...) pupil reactivity. In addition, nearly all nurses relied on subjective estimation, even when tools were available.Critical care and neurosurgical nurses underestimated pupil size, were unable to detect anisocoria, and incorrectly assessed pupil reactivity. Standardized use of pupil assessment tools such as a pupillometer is necessary to increase accuracy and consistency in pupil measurement and to potentially contribute to earlier detection of subtle changes in pupils. If pupillary changes

2016 American Journal of Critical Care

69. Brown-Séquard syndrome without vascular injury associated with Horner's syndrome after a stab injury to the neck Full Text available with Trip Pro

and optimizing function after Brown-Séquard spinal cord injury are important roles for the rehabilitation team. Imaging is necessary to rule out cord hemorrhage or vascular injury and to clinically correlate cord damage with physical examination findings and expected functional impairments. Documenting associated anisocoria and explaining this finding to the patient is an important element of spinal cord injury education. Commonly, patients with Brown-Séquard injuries demonstrate remarkable motor recovery

2016 The journal of spinal cord medicine

70. Delayed Acute Subdural Hematoma Associated With Percutaneous Coronary Intervention Full Text available with Trip Pro

arrhythmia. She had hit her head on the road. The initial CT did not reveal any hemorrhage in the intra-cranium. She fully recovered after PCI. However, 1 hour after PCI, she lost consciousness and immediate CT showed acute subdural hematoma and subarachnoid hemorrhage. The period from losing consciousness to brain herniation presenting as anisocoria was very short-only 30 minutes in our patient. Although emergent evacuation of hematoma and external decompression were performed, the patient died 1 day

2016 The Journal of craniofacial surgery

71. “Don't Believe Your Eyes” Ipratropium Induced Mydriasis: A Case Report and Review of the Literature Full Text available with Trip Pro

“Don't Believe Your Eyes” Ipratropium Induced Mydriasis: A Case Report and Review of the Literature Unilateral fixed mydriasis can be an ominous sign; however in many cases, it is benign and represents pharmacologic mediated action on the iris dilator or sphincter. Differentiation between pharmacologic mediated anisocoria and physiologic anisocoria can be challenging but may save on costly imaging. An 83 year-old woman was admitted with critical limb ischemia and subsequently developed (...) respiratory failure treated with positive pressure ventilation and ipratropium nebulizers. She was noted to have left unilateral mydriasis without other neurologic deficits. Brain magnetic resonance imaging with MR angiography showed no evidence for a mass lesion or posterior communicating artery aneurysm. Her anisocoria self-resolved within 36 hours after nebulizer treatments were stopped. Ipratropium bromide is one of the most common medications used in the hospital setting and should be consider

2016 General medicine (Los Angeles, Calif.)

72. Digital Pupillometry in Normal Subjects Full Text available with Trip Pro

. The absolute linear camera resolution was approximately 20 pixels per mm. This cross-sectional study analysed 490 eyes of 245 subjects (mean age: 51.9 ± 18.3 years, range: 6-87 years). On average, pupil diameter decreased with increasing light intensities for both eyes, with a mean pupil diameter of 5.39 ± 1.04 mm at 0 lux, 5.20 ± 1.00 mm at 0.5 lux, 4.70 ± 0.97 mm at 4 lux, 3.74 ± 0.78 mm at 32 lux, and 2.84 ± 0.50 mm at 250 lux illumination. Furthermore, it was found that anisocoria increased by 0.03 mm (...) per life decade for all illumination levels (R2 = 0.43). Anisocoria was higher under scotopic and mesopic conditions. This study provides additional information to the current knowledge concerning age- and light-related pupil size and anisocoria as a baseline for future patient studies.

2016 Neuro-Ophthalmology

73. A Rare Case of Penetrating Trauma Resulting in Isolated Third Nerve Palsy Full Text available with Trip Pro

of a traumatic injury were present. The patient was observed for 14 months, during which he continually improved, with almost complete resolution of his diplopia, anisocoria, and ptosis.

2016 Neuro-Ophthalmology

74. Reliability of standard pupillometry practice in neurocritical care: an observational, double-blinded study Full Text available with Trip Pro

condition with NeuroLight Algiscan pupillometer. During another period, we conducted a prospective, observational, double-blinded study in two neurocritical care units. Patients admitted to these units after an acute brain injury were included. Initially, nursing staff measured pupil size, anisocoria and pupillary light reflex. A blinded physician subsequently performed measurement using an automated pupillometer.In 200 healthy volunteers, intra-class correlation coefficient for maximum resting pupil (...) , IC: 0.70-0.79; P < 0.001). Nursing staff failed to diagnose half of the cases (15/30) of anisocoria detected using the pupillometer device. A global rate of discordance of 18% (72/406) was found between the two techniques when assessing the pupillary light reflex. For measurements with small pupils (diameters <2 mm) the error rate was 39% (24/61).Standard practice in pupillary monitoring yields inaccurate data. Automated quantitative pupillometry is a more reliable method with which to collect

2016 Critical Care

75. A Rare Case in the Emergency Department: Holmes-Adie Syndrome Full Text available with Trip Pro

is the absence of deep tendon reflexes, and unilateral involvement is more common. This case report emphasizes that HAS should be considered in the differential diagnosis of patients presenting to the emergency department with anisocoria, and the dilute pilocarpine test can be used in diagnosis.

2016 Turkish journal of emergency medicine

76. Emergency decompressive craniectomy after removal of convexity meningiomas Full Text available with Trip Pro

and pupillary anisocoria. Computed tomography revealed no postoperative hematoma, however, did indicate increased brain edema and ventricular shift (mean: 12 mm). Emergency decompressive craniectomy and brief ventilator assistance were performed in all patients. Ischemia of the ipsilateral posterior cerebral artery occurred in 3 patients and hydrocephalus occurred in 2 patients. Outcome was good in 2, fair in 2, 1 patient had severe disability, and 1 patient died after 8 months.Brain shift on preoperative

2016 Surgical neurology international

77. Pupillometry Dynamic Measures in Patients Without Ocular or Neurological Disease

disease Ametropia inferior to 3 diopters for spherical correction and inferior to 1.50 diopter for astigmatism correction Matched for age and sex with one of the 22 subjects of the patients' unilateral NORB database Exclusion Criteria: history of disease affecting pupillary motility anisocoria patient under legal protection pregnant or breast feeding patient patient's refusal to participate in the study no medical insurance coverage Contacts and Locations Go to Information from the National Library

2016 Clinical Trials

78. Performance of a Photoscreener for Vision Screening in a Haitian Pediatric Population

in front him. The spot then evaluates for refractive errors, anisocoria, strabismus, ptosis and media opacity. The ophthalmologic evaluation consists of the measure of the visual acuity, ocular alignment, anterior and posterior segment. The patient will be cyclopleged with cycloplegic drops and will be refracted to obtain a cyclopleged refraction. This will determine his refractive error. Device: Spot photoscreener Screening of vision problem through an automated device Procedure: Ophthalmologic

2016 Clinical Trials

79. The Effect of Brimonidine on Intraocular Pressure When Dilating Routine Patients

Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: Healthy with no major medical conditions. Contact lens wear is ok but must be not worn on the day of the study Exclusion Criteria: Diabetic, history of glaucoma history of iris trauma history of eye surgery except LASIK or Photorefractive keratectomy laser eye surgery Anisocoria pregnancy Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study

2016 Clinical Trials

80. Is the RAPDx Pupillograph Able to Distinguish Between Glaucoma Subjects and Healthy Subjects?

angles on gonioscopy. Exclusion Criteria: Abnormal ocular motility that prevents binocular fixation (e.g. strabismus, nystagmus). Any condition preventing adequate visualization and examination of the pupil or optic nerve (e.g. dense corneal opacities or lens opacities). Active infection of the anterior or posterior segments of the eye. Any intraocular surgical or laser procedure within the previous 4 weeks. Any non-glaucomatous condition that may cause an RAPD, anisocoria or corectopia (ex. optic

2015 Clinical Trials

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