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161. But It's Not All There. (Abstract)

But It's Not All There. A 44-year-old man presented with acute onset headache and isolated anisocoria. Dilation lag was noted in the smaller pupil and Horner syndrome was suspected despite the lack of eyelid ptosis. Cocaine testing confirmed the clinical diagnosis, and urgent neuroimaging found an internal carotid artery dissection. The patient was managed with systemic anticoagulation with a good final outcome. Horner syndrome should be suspected in any patient with aniscoria and dilation lag

2012 Survey of Ophthalmology

162. Inequality of the direct and consensual light reflexes in normal subjects. (Full text)

Inequality of the direct and consensual light reflexes in normal subjects. Anisocoria in darkness and during reflex responses to unilateral light stimulation was studied in 150 normal subjects with television pupillometry. It was commonly found that the direct light reaction of the stimulation eye exceeded the consensual reaction of the other eye. This light-induced anisocoria, termed 'contraction anisocoria', had a mean value of 0.075 mm or 6.1 % of light reflex amplitude. The measurement (...) showed a high degree of repeatability in 20 subjects who were tested on two occasions a year apart. It occurred in the presence and absence of prior dark adaptation and increased proportionally with reflex amplitude as the intensity of the stimulating light was raised. IT IS CONCLUDED THAT, CONTRARY TO PREVIOUS OPINION, A SMALL DEGREE OF CONTRACTION ANISOCORIA IS NORMAL.

1979 The British journal of ophthalmology PubMed abstract

163. Horner Syndrome

degenerated; the result is increased anisocoria. If the lesion is below the superior cervical ganglion (preganglionic or central Horner syndrome) and the postganglionic fibers are intact, the pupil of the affected eye also dilates, and anisocoria decreases. Apraclonidine : Apraclonidine is a weak alpha-adrenergic agonist that minimally dilates the pupil of a normal eye. If a postganglionic lesion is present (peripheral Horner syndrome), the pupil of the affected eye dilates much more than (...) that of the unaffected eye because the iris dilator muscle of the affected eye has lost its sympathetic innervation and has developed adrenergic supersensitivity. As a result, anisocoria decreases. (However, results may be falsely normal if the causative lesion is acute.) If the lesion is preganglionic (or a central Horner syndrome), the pupil of the affected eye does not dilate because the iris dilator muscle does not develop adrenergic supersensitivity; as a result, anisocoria increases. If results suggest Horner

2013 Merck Manual (19th Edition)

164. Cavernous Sinus Thrombosis

with cavernous sinus thrombosis may also have anisocoria or mydriasis (3rd cranial nerve dysfunction), papilledema, and vision loss. Diagnosis MRI or CT Cavernous sinus thrombosis is often misdiagnosed because it is rare. It should be considered in patients who have signs consistent with . Features that distinguish cavernous sinus thrombosis from orbital cellulitis include cranial nerve dysfunction, bilateral eye involvement, and mental status changes. Diagnosis is based on neuroimaging. MRI is the better

2013 Merck Manual (19th Edition)

165. Overview of Neuro-ophthalmologic and Cranial Nerve Disorders

light. If an efferent defect is present, the pupil responds sluggishly or does not respond to both direct and consensual light. Table Common Pupillary Abnormalities Finding Explanation Asymmetry of 1–2 mm between pupils, preserved light responses, and no symptoms Normal variant (physiologic anisocoria) Asymmetry, impaired light responses, and preserved response to accommodation (light-near dissociation or Argyll Robertson pupil) Neurosyphilis (possibly) Bilateral constriction Opioids Miotic eye

2013 Merck Manual (19th Edition)

166. Decompressive craniectomy in 14 children with severe head injury: clinical results with long-term follow-up and review of the literature. (Abstract)

Coma Scale score was 6.5 (range, 4-15). Ten patients were presented with anisocoria. In 13 patients, craniectomy initially decreased ICP to <25 mm Hg. Two patients (14%) had a poor prognosis on admission and died. The most frequent complications were hygroma (8 patients) and infections (3 patients). The mean Glasgow Outcome Scale score at the 2-year follow-up visit was 4.4 (range, 4-5). Behavioral and psychiatric abnormalities and poor academic performance were frequent (82%).DC reduces ICP

2011 Journal of Trauma

167. Ciliary ganglion

in roughly 1 out of every 500 people. A patient with anisocoria (one pupil bigger than the other) whose pupil does not react to light (does not constrict when exposed to bright light) most likely has Adie syndrome – idiopathic degeneration of the ciliary ganglion. Physiology [ ] The strange behavior of tonic pupils was first explained by Irene Loewenfeld in 1979. The ciliary ganglion contain many more nerve fibers directed to the ciliary muscle than nerve fibers directed to the constrictor pupillae

2012 Wikipedia

168. The sequential trauma score - a new instrument for the sequential mortality prediction in major trauma* (Full text)

that age was a significant predictor of survival (AUC(model P), area under the curve = 0.63). Logistic regression of the prehospital data (A) showed that blood pressure, pulse rate, Glasgow coma scale (GCS), and anisocoria were significant predictors (AUC(model A) = 0.76; AU(model P + A) = 0.82). Logistic regression of the early trauma room phase (B1) showed that peripheral oxygen saturation, GCS, anisocoria, base excess, and thromboplastin time to be significant predictors of survival (AUC(model B1

2010 European Journal Of Medical Research PubMed abstract

169. Spontaneous Intracranial Epidural Hematoma Originating from Dural Metastasis of Hepatocellular Carcinoma (Full text)

Spontaneous Intracranial Epidural Hematoma Originating from Dural Metastasis of Hepatocellular Carcinoma Spontaneous intracranial epidural hematoma (EDH) due to dural metastasis of hepatocellular carcinoma is very rare. A 53-year-old male patient with hepatocellular carcinoma, who was admitted to the department of oncology, was referred to department of neurosurgery because of sudden mental deterioration to semicoma with papillary anisocoria and decerebrate rigidity after transarterial

2010 Journal of Korean Neurosurgical Society PubMed abstract

170. February cover (Full text)

February cover 20393087 2012 03 26 2013 11 21 1715-5258 56 4 2010 Apr Canadian family physician Medecin de famille canadien Can Fam Physician February cover. 329; author reply 330 Dickson Robert C RC eng Letter Canada Can Fam Physician 0120300 0008-350X 0 Bronchodilator Agents QF8SVZ843E Albuterol IM Albuterol administration & dosage Anisocoria pathology Bronchodilator Agents administration & dosage Child Humans Male Metered Dose Inhalers Strabismus 2010 4 16 6 0 2010 4 16 6 0 2012 3 27 6 0

2010 Canadian Family Physician PubMed abstract

171. The Trauma- Formula-Driven Versus Lab-Guided Study (TRFL Study)

(defined as any of the following: Glasgow Coma Scale of 3 due to severe traumatic brain injury; clear indication of immediate neurosurgical intervention based on clinical findings, mechanism of trauma associated with focal signs (anisocoria, CT evidence of intracranial bleeding with mass effect); or iv) they had evidence of having a catastrophic head injury (such as transcranial gunshot wound, open skull fracture with exposure/loss of brain tissue, or expert opinion by either the trauma team leader

2009 Clinical Trials

172. Duration and predictors of emergency surgical operations - basis for medical management of mass casualty incidents (Full text)

) and anisocoria (OR 1,28) on-scene.The mean operation time of 130min calculated for emergency life-saving surgical operations provides a realistic guideline for the prospective treatment capacity which can be estimated and projected into an actual incident admission capacity. Knowledge of predictive factors for life-saving emergency operations helps to identify those patients that need most urgent operative treatment in case of blunt MCI.

2009 European Journal Of Medical Research PubMed abstract

173. Monitoring intracranial pressure in patients with malignant middle cerebral artery infarction: is it useful? (Full text)

on the first CT scan and underwent surgery without prior ICP monitoring. This study focuses on the subgroup of 19 patients who underwent intraparenchymatous ICP monitoring before surgery.Intracranial pressure readings were evaluated and correlated with pupillary abnormalities, MLS, and ischemic tissue volume. In 12 of the 19 patients, ICP values were always < or = 20 mm Hg, despite a mean (+/- SD) MLS of 6.7 +/- 2 mm and a mean ischemic tissue volume of 241.3 +/- 83 cm(3). In 2 patients with anisocoria

2009 Journal of Neurosurgery PubMed abstract

174. Emergency Department Skull Trephination for Epidural Hematoma in Patients Who Are Awake But Deteriorate Rapidly. (Abstract)

in the age of computed tomography (CT) scanning.Patients with EDH from blunt trauma, either in our institution or known to our graduate network, who were T&D with anisocoria despite intubation plus medical therapy, and who had pre-transfer EP trephination, were compared to those who were transferred without trephination.There were 5 patients with blunt trauma and CT-proven EDH who were T&D with anisocoria who underwent Emergency Department (ED) trephination at outlying hospitals before transfer. All 5 (...) had improvement in condition and good outcomes. Three had complete recovery without disability and 2 others had mild disability with good cognitive function. None had complications. Two patients with T&D and anisocoria were transferred without trephination. Both had good neurologic outcomes. The mean time to pressure relief in the trephination group vs. transfer group was 55 vs. 207 min, respectively.In T&D patients with CT-proven EDH and anisocoria, ED skull trephination before transfer resulted

2009 Journal of Emergency Medicine

175. Unilateral mydriasis Due to hemorrhoidal ointment. (Abstract)

Unilateral mydriasis Due to hemorrhoidal ointment. The finding of a unilaterally dilatated pupil in a patient who is otherwise alert and unimpaired can pose an interesting diagnostic problem. Algorithms have outlined the approach to evaluating anisocoria, but do not stress the importance of toxic exposures.A patient with a history of depression and chronic headaches was referred to the emergency department from an ophthalmologist's clinic with the findings of asymmetrically dilatated pupils

2009 Journal of Emergency Medicine

176. Mortality in severe traumatic brain injury: a multivariated analysis of 748 Brazilian patients from Florianópolis City. (Abstract)

= 5.56-23.87, p < 0.0001), or anisocoria (OR = 2.65, 95% CI = 1.69-4.17, p < 0.0001) in comparison to isocoric pupils. There was a trend for higher mortality in patients with type III injury on the Marshall classification of CT (OR = 3.63, 95% CI = 0.84-15.76, p = 0.08) than in patients with normal CT. Patients without thoracic trauma disclose higher mortality than patients with associated thoracic trauma do (OR = 2.02, 95% CI = 1.19-3.41, p = 0.009). The final model presented disclosed 76.9

2009 Journal of Trauma

177. A 14-year follow-up of photorefractive keratectomy. (Abstract)

logMAR -0.11 +/- 0.55, and BSCVA logMAR -0.03 +/- 1.00. At 14 years, BSCVA for most eyes was at least equal to preoperative BSCVA. In both groups, haze increased between 3 and 6 months, then declined in the first year. A temporary increase of IOP was seen in 4 eyes. Complications were minor haze (2 eyes), transient anisocoria (9 eyes), and intraepithelial hemosiderin deposits (4 eyes). No abnormalities in endothelial cell count or morphology, astigmatism, or ectasia were noted. Three patients

2009 Journal of Refractive Surgery

178. Effect of Brimonidine Tartrate Ophthalmic Solution 0.15% on Pupil Diameter in Normal Eyes

females of childbearing potential will have pregnancy test prior to participating in study) History of serious ocular, neurological, cardiovascular disease History of severe systemic disease History of arrhythmias or high blood pressure Patients currently taking any type of ocular or systemic medications except multivitamins. Patients with abnormal pupil shape, Addie's pupil, anisocoria, or abnormal pupil defect. Contacts and Locations Go to Information from the National Library of Medicine To learn

2006 Clinical Trials

179. Diagnostic Ophthalmology (Full text)

Canada Can Vet J 0004653 0008-5286 IM Animals Anisocoria diagnosis etiology pathology veterinary Diagnosis, Differential Dog Diseases diagnosis pathology Dogs Fatal Outcome Ophthalmoplegia complications diagnosis pathology veterinary Vocal Cord Paralysis diagnosis etiology pathology veterinary 2007 4 18 9 0 2007 5 8 9 0 2007 4 18 9 0 ppublish 17436913 PMC1800946 Semin Vet Med Surg (Small Anim). 1990 Feb;5(1):24-36 2191391 J Am Anim Hosp Assoc. 2002 Jan-Feb;38(1):55-9 11804316 J Am Vet Med Assoc. 2002

2007 The Canadian Veterinary Journal PubMed abstract

180. Regression of Urrets-Zavalia Syndrome After Deep Lamellar Keratoplasty for Keratoconus: A Case Study (Full text)

Regression of Urrets-Zavalia Syndrome After Deep Lamellar Keratoplasty for Keratoconus: A Case Study We report a case of pharmacologic regression of Urrets-Zavalia syndrome, following deep lamellar keratoplasty for severe keratoconus. Sympatholytic and parasympathomimetic drops were administered and a progressive reduction of mydriasis and restoring of pupillary kinetics were observed. Four years after surgery, it was resulting in only slight residual anisocoria.

2008 The open ophthalmology journal PubMed abstract

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