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Quantitative Pupillometry Predicts Neurologic Deterioration in Patients with Large Middle Cerebral Artery Stroke.
Ann Neurol
January 2025
Department of Neurology, Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
Objective: This study assesses whether longitudinal quantitative pupillometry predicts neurological deterioration after large middle cerebral artery (MCA) stroke and determines how early changes are detectable.
Methods: This prospective, single-center observational cohort study included patients with large MCA stroke admitted to Boston Medical Center's intensive care unit (2019-2024). Associations between time-to-neurologic deterioration and quantitative pupillometry, including Neurological Pupil Index (NPi), were assessed using Cox proportional hazards models with time-dependent covariates adjusted for age, sex, and Alberta Stroke Program Early CT Score.
Automated quantitative pupillometry as a predictor for transtentorial brain herniation in patients with malignant acute ischemic stroke.
PLoS One
January 2025
Department of Convergence of Healthcare and Medicine, Ajou University Graduate School of Medicine, Suwon, South Korea.
Brain herniation can be a life-threatening condition, resulting in poor prognosis and higher fatality rates. We examined whether quantitative characteristics of sequential pupillary light reflex (PLR) could serve as biomarkers for identifying brain herniation in fatal acute stroke cases with anterior circulation involvement admitted to neurological intensive care unit (Neuro-ICU). Automatic pupillometer assessed PLR automatically every 4-6 hours, measuring eight specific features: NPi (Neurological pupil index) score, initial resting and constriction pupil size, constriction change, constriction velocity, constriction latency, and dilation velocity.
View Article and Find Full Text PDFEvaluating optic system compression in sellar tumors: A novel application of quantitative pupillometry.
Acta Neurochir (Wien)
December 2024
Medical Faculty of Heidelberg University, Heidelberg, Germany.
Introduction: Tumorous growths in the sellar region pose significant clinical challenges due to their proximity to critical visual structures such as the optic chiasm and optic nerves. Given their proximity to the optic system, these tumors are often diagnosed due to a progressive decrease in visual acuity. Thus, surgical intervention is crucial to prevent irreversible damage, as timely decompression can halt the progression of edema and subsequent optic atrophy.
View Article and Find Full Text PDFQuantitative pupillometry as a potential biomarker in early concussion assessment.
J Clin Neurosci
December 2024
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA. Electronic address:
Background: There are limited objective methods when it comes to identifying and diagnosing concussion. Pupil assessment is performed routinely as a standard-of-care following traumatic brain injury (TBI). Unlike the highly subjective and limited reliability of pupil assessment using penlights and flashlights, Quantitative pupillometry (QP) is an established, valid, and reliable method of pupillary assessment.
View Article and Find Full Text PDFThere Is Significant Within-Subject Variation in the Time from Light Stimulus to Maximum Pupil Constriction Among Healthy Controls.
J Clin Med
December 2024
Department of Neurology, The University of Texas Southwestern Medical Center (UTSW), Dallas, TX 75390, USA.
: Handheld quantitative pupilometers (QPs) measure each phase of the pupillary light reflex (PLR) and provide a summary score based on these values. One phase of the PLR is the period of time from the onset of light exposure to the maximum constriction of the pupil, also known as time to maximum constriction (tMC). Although tMC has been found to vary significantly among patients with neurological injury, there are no studies reporting tMC in healthy controls.
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