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Performance of the quantitative pupillary light reflex and neurological pupil index for predicting neurological outcomes in cardiac arrest patients: A systematic review and meta-analysis.
Medicine (Baltimore)
January 2025
Emergency Department, Baoding No. 1 Central Hospital, Lianchi District, Baoding City, China.
Background: The performance of quantitative pupillary light reflex (qPLR) and the neurological pupil index (NPi) was used to predict neurological outcomes in cardiac arrest (CA) patients.
Methods: Eligible studies on the ability of the qPLR and NPi to predict neurological outcomes in CA patients were searched from the PubMed and China National Knowledge Infrastructure databases until July 2023. The pooled odds ratio (OR) and its 95% confidence interval (95% CI), area under the curve, sensitivity analysis, and publication bias were analyzed via Stata 14.
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.
Adie's pupil and systemic manifestations: a rare unilateral presentation.
GMS Ophthalmol Cases
December 2024
Department of Neuro-Ophthalmology, Aravind Eye Hospital and Postgraduate Institute, Coimbatore, India.
We present a case of a young woman who presented with blurring of vision in her right eye, worsening on near work. Detailed ophthalmic and neurological evaluation was done, which revealed light near dissociation, vermiform iris movements, constriction to diluted pilocarpine with absent deep tendon reflexes. Laboratory investigation indicated mild iron deficiency anemia and reduced vitamin D3 level.
View Article and Find Full Text PDFDecompressive Craniectomy and Hinged Craniotomy for Traumatic Brain Injury: Experience in Two Centers in a Middle-Income Country.
Korean J Neurotrauma
December 2024
Department of Neurosurgery, Fundación Universitaria de Ciencias de la Salud (FUCS), Hospital de San José - Sociedad de Cirugía de Bogotá, Bogotá, Colombia.
Objective: The goal of a decompressive craniectomy (DC) or a hinge craniotomy (HC), is to treat intracranial hypertension and reduce mortality. Traditionally, the decompression procedure has been performed with cranial bone removal. However, decompression and repositioning the cranial bone, named HC, has been presented as an alternative for certain cases.
View Article and Find Full Text PDFAutomated 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.
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