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pupillary reactivity

F Javaudin, B Leclere, J Segard, Q Le Bastard, P Pes, Y Penverne, P Le Conte, J Jenvrin, H Hubert, J Escutnaire, E Batard, E Montassier, A C Gr-Ré
INTRODUCTION: Loss of pupillary light reactivity (PLR) three days after a cardiorespiratory arrest is a prognostic factor. Its predictive value upon hospital admission remains unclear. Our objective was to determine the prognostic value of the absence of PLR upon hospital admission in patients with out-of-hospital cardiac arrest. METHODS: We prospectively included all out-of-hospital cardiac arrests occurring between July 2011 and July 2017 treated by a mobile medical team (MMT) based on data from a French cardiac arrest registry database...
March 12, 2018: Resuscitation
Marie-Anne Vanderhasselt, Rudi De Raedt, Selene Nasso, Louise Puttevils, Sven C Mueller
Human beings have a basic need for esteemed social connections, and receiving negative self-evaluative feedback induces emotional distress. The aim of the current study is to measure eye movements (a physiological marker of attention allocation) and pupillary responses (a physiological marker of cognitive and emotional processing) as online and objective indices of participants' reaction to positive/negative social evaluations from the same or opposite sex. Following the paradigm, subjective mood ratings and heart rate variability (HRV) - as an objective index of regulatory effort- were measured...
March 3, 2018: Biological Psychology
Naresh Mullaguri, Nakul Katyal, Aarti Sarwal, Jonathan M Beary, Pravin George, Naresh Karthikeyan, Premkumar Nattanamai, Christopher R Newey
Although a neurological examination is fundamental to the evaluation of comatose patients, it is less reliable in a medically induced coma. A commonly misinterpreted finding in patients in a pentobarbital coma is altered pupillary reactivity secondary to an exaggerated ciliospinal reflex. Recognizing an exaggerated ciliospinal reflex in patients in a pentobarbital coma is important and may prevent unnecessary intervention. We present a patient induced in a pentobarbital coma for the treatment of status epilepticus who exhibited a nonreactive pupil secondary to an exaggerated ciliospinal reflex confirmed by pupillometry...
December 30, 2017: Curēus
Adam M H Young, Joseph Donnelly, Xiuyun Liu, Mathew R Guilfoyle, Melvin Carew, Manuel Cabeleira, Danilo Cardim, Matthew R Garnett, Helen M Fernandes, Christina Haubrich, Peter Smielewski, Marek Czosnyka, Peter J Hutchinson, Shruti Agrawal
OBJECTIVE:  Although secondary insults such as raised intracranial pressure (ICP) or cardiovascular compromise strongly contribute to morbidity, a growing interest can be noticed in how the pre-hospital management can affect outcomes after traumatic brain injury (TBI). The objective of this study was to determine whether pre-hospital co-morbidity has influence on patterns of continuously measured waveforms of intracranial physiology after paediatric TBI. MATERIALS AND METHODS: Thirty-nine patients (mean age, 10 years; range, 0...
2018: Acta Neurochirurgica. Supplement
Alexander Papangelou, Elizabeth K Zink, Wan-Tsu W Chang, Anthony Frattalone, Daniel Gergen, Allan Gottschalk, Romergryko G Geocadin
Introduction: Transtentorial herniation (TTH) is a life-threatening neurologic condition that typically results from expansion of supratentorial mass lesions. A change in bedside pupillary examination is central to the clinical diagnosis of TTH. Materials and. Methods: To quantify the changes in the pupillary examination that precede and accompany TTH and its treatment, we evaluated 12 episodes of herniation in three patients with supratentorial mass lesions using automated pupillometry (NeurOptics, Inc...
January 1, 2018: Military Medicine
Qiang Yuan, Jian Yu, Xing Wu, Yi-Rui Sun, Zhi-Qi Li, Zhuo-Ying Du, Xue-Hai Wu, Jin Hu
BACKGROUND: Coagulopathy is commonly observed after traumatic brain injury (TBI). However, it is not known whether using the standard independent predictors in conjunction with coagulation tests would improve their prognostic value. We determined the incidence of TBI-associated coagulopathy in patients with isolated TBI (iTBI), evaluated the prognostic value of coagulation tests for in-hospital mortality, and tested their predictive power for in-hospital mortality in patients with iTBI...
January 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Maighdlin Anderson, Jonathan Elmer, Lori Shutter, Ava Puccio, Sheila Alexander
In the setting of acute traumatic brain injury (TBI), an abnormal pupil assessment may suggest a worsening intracranial lesion. Early detection of pupillary changes may expedite emergent care to improve outcomes. Automated, handheld pupillometers have been commercially available for 20 years, and several studies suggest that their use may facilitate early recognition of worsening injury and intracranial hypertension. The use of pupillometry as a bedside tool in the routine care of patients with severe TBI (Glasgow Coma Scale score ≤ 8) has not been described...
February 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Jeremy A Elman, Matthew S Panizzon, Donald J Hagler, Lisa T Eyler, Eric L Granholm, Christine Fennema-Notestine, Michael J Lyons, Linda K McEvoy, Carol E Franz, Anders M Dale, William S Kremen
Pupillary responses during cognitive tasks are linked to functioning of the locus coeruleus (LC). The LC is an early site of abnormal tau deposition, which may contribute to key aspects of Alzheimer's disease (AD) pathophysiology. We previously found attenuation of pupillary responses to increases in cognitive load in individuals with mild cognitive impairment (MCI), suggesting pupillary responses may provide a biomarker of early risk for AD associated with LC dysfunction. The LC modulates cortical activity through two modes of operation: tonic and phasic...
December 2017: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
Niklas Marklund
The most fundamental clinical monitoring tool in traumatic brain injury (TBI) patients is the repeated clinical examination. In the severe TBI patient treated by continuous sedation in a neurocritical care (NCC) unit, sedation interruption is required to enable a clinical evaluation (named the neurological wake-up test; NWT) assessing the level of consciousness, pupillary diameter and reactivity to light, and presence of focal neurological deficits. There is a basic conflict regarding the NWT in the NCC setting; can the clinical information obtained by the NWT justify the risk of inducing a stress response in a severe TBI patient? Furthermore, in the presence of advanced multimodal monitoring and neuroimaging, is the NWT necessary to identify important clinical alterations? In studies of severe TBI patients, the NWT was consistently shown to induce a stress reaction including brief increases in intracranial pressure (ICP) and changes in cerebral perfusion pressure (CPP)...
2017: Frontiers in Neurology
Alkinoos Athanasiou, Ioannis Balogiannis, Ioannis Magras
BACKGROUND: Lasting bilateral mydriasis and absence of pupillary light reflex following severe traumatic brain injury (TBI) are considered signs of irreversible brainstem damage and have been strongly associated with poor outcome. CASE DESCRIPTION: A young female patient presented with severe TBI, contusions, and diffuse brain edema. She was initially treated medically, but developed delayed secondary refractory intracranial hypertension and bilaterally dilated, non-reactive pupils for 12 h...
2017: Surgical Neurology International
Ilknur Tugal-Tutkun, Luca Cimino, Yonca Aydin Akova
Varicella zoster virus (VZV)-induced anterior uveitis (AU) may complicate the course of primary varicella infection typically seen in children. In adults, especially with advanced age, VZV AU is more commonly associated with herpes zoster ophthalmicus (HZO) with or without skin rash affecting the distribution of the ophthalmic nerve due to reactivation of the latent VZV in the trigeminal ganglion. While it is typically a mild self-limiting AU in primary infection, HZO AU is often accompanied by keratitis, may have a chronic recurrent course, and lead to sectoral iris atrophy, pupillary distortion, and ocular hypertension...
2018: Ocular Immunology and Inflammation
Sara Iacozza, Albert Costa, Jon Andoni Duñabeitia
Foreign languages are often learned in emotionally neutral academic environments which differ greatly from the familiar context where native languages are acquired. This difference in learning contexts has been argued to lead to reduced emotional resonance when confronted with a foreign language. In the current study, we investigated whether the reactivity of the sympathetic nervous system in response to emotionally-charged stimuli is reduced in a foreign language. To this end, pupil sizes were recorded while reading aloud emotional sentences in the native or foreign language...
2017: PloS One
Tatsuya Maekawa, Hironobu Tadaki, Tomohiko Sasase, Yu Motohashi, Katsuhiro Miyajima, Takeshi Ohta, Shinichi Kume
INTRODUCTION: To establish an animal model for diabetic peripheral neuropathy (DPN) at an earlier stage, we performed functional and pathophysiological evaluations in Spontaneously Diabetic Torii (SDT) fatty rats before 16weeks of age. METHODS: Male SDT fatty rats were treated with vehicle or phlorizin (100 to 150mg/kg/day) from 5 to 16weeks. Sprague-Dawley (SD) rats were used as age-matched controls. Body weights and biochemical parameters were measured over time...
September 29, 2017: Journal of Pharmacological and Toxicological Methods
Sandhya Mangalore, Kotresh, Rakshith Srinivasa, Alangar Sathyaranjandas Hegde, Rangashetty Srinivasa
BACKGROUND: Trans Cranial Colour Doppler (TCCD) has been extensively used in various neurological and neurosurgical conditions causing severe raise in the intracranial pressure (ICP). MATERIAL AND METHOD: Our study explores the sequential evolution of TCCD flow pattern by correlating with pupillary reactivity, Glasgow coma scale (GCS), and imaging. Our cohort consisted of thirty patients with ten patients in each subgroup admitted to the neuro-Intensive Care Unit (NICU) for various neurological and neurosurgical causes...
July 2017: Annals of Indian Academy of Neurology
Jian-Li Wang, Guo-Liang Jin, Zi-Gang Yuan
OBJECTIVE: This study aimed to explore relevant factors of hemorrhagic contusions following decompressive craniotomy (DC) in traumatic brain injury (TBI), and create an artificial neural network (ANN) prediction model of the risk factors of hemorrhagic contusions. METHODS: This study analyzed 425 patients with TBI who underwent DC in the Neurosurgery Department of Shaoxing People's Hospital between 2009 and 2014. Patients were divided into two groups according to the first postoperative CT scans: hemorrhage group and non-hemorrhage group...
September 7, 2017: Journal of Neurosurgical Sciences
Julian Xinguang Han, Angela An Qi See, Mihir Gandhi, Nicolas Kon Kam King
OBJECTIVE: Current prognostic models for traumatic brain injury (TBI) are developed from diverse historical data sets. We aimed to construct a prognostication tool for patients with severe TBI, as this group would benefit most from an accurate model. METHODS: Model development was based on a cohort of 300 patients with severe TBI (Glasgow Coma Scale score ≤8) consecutively admitted to a neurosurgical intensive care unit at the National Neuroscience Institute (NNI), Singapore, between February 2006 and December 2009...
December 2017: World Neurosurgery
Matthew Hao Lee, Biswadev Mitra, Jiun Kae Pui, Mark Fitzgerald
BACKGROUND: Traumatic brain injury (TBI) is a significant public health issue. Assessing pupil reactivity is a crucial aspect of its management and the pupillometer has been shown to be a more objective tool compared to the standard penlight. Its use, however, is not widespread. OBJECTIVE: To investigate the paucity in uptake, we examined the frequency of use of pupillometers (NeurOptics(®)NPi-100™) amongst Intensive Care Unit (ICU) doctors and nurses, evaluated its user-friendliness and explored barriers to its use...
July 17, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Randall M Chesnut, Nancy Temkin, Sureyya Dikmen, Carlos Rondina, Walter Videtta, Gustavo Petroni, Silvia Lujan, Victor Alanis, Antonio Falcao, Gustavo de la Fuenta, Luis Gonzalez, Manuel Jibaja, Arturo Lavarden, Freddy Sandi, Roberto Mérida, Ricardo Romero, Jim Pridgeon, Jason Barber, Joan Machamer, Kelley Chaddock
The imaging and clinical examination (ICE) algorithm used in the Benchmark Evidence from South American Trials: Treatment of Intracranial Pressure (BEST TRIP) randomized controlled trial is the only prospectively investigated clinical protocol for traumatic brain injury management without intracranial pressure (ICP) monitoring. As the default literature standard, it warrants careful evaluation. We present the ICE protocol in detail and analyze the demographics, outcome, treatment intensity, frequency of intervention usage, and related adverse events in the ICE-protocol cohort...
January 1, 2018: Journal of Neurotrauma
DaiWai M Olson, Sonja E Stutzman, Folefac Atem, Julia D Kincaide, Thuy-Tien Ho, Byron A Carlisle, Venkatesh Aiyagari
BACKGROUND: Trained medical practitioners have been assessing the pupillary light reflex for more than 2 millennia. However, the interrater reliability of the pupillary light reflex remains low. To overcome the drawbacks of a subjective interpretation of pupillary size and reactivity, automated pupillometers are becoming increasingly commonplace, but practitioners do not have adequate data from which to judge whether the numerical values provided by the pupillometer are "within reference limits...
August 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Rolf Erlebach, Alberto Pagnamenta, Stephanie Klinzing, Federica Stretti, Silvia Cottini, Reto Schüpbach, Peter Steiger, Giovanna Brandi
BACKGROUND: Study-purpose is to analyze clinical features of patients with traumatic brain injury (TBI), their age-related outcomes and determinants of long- term outcome. METHODS: This retrospective cohort study was conducted in a level I University Swiss trauma center. Consecutive patients with moderate to severe TBI admitted for more than 48 hours to the Intensive Care Unit were included. Patients' and trauma characteristics, management during ICU-stay, prognostic scores and long- term outcomes were analyzed...
June 22, 2017: Minerva Anestesiologica
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