Pupil changes in trauma

[vc85]

So I've been doing some of my own reading on this topic and was wondering. In a closed head injury, would you expect to see a unilateral sluggish pupil before ALOC or loss of consciousness and Cushings triad?

What about in a concussion ?

 

[MSDeltaFlt]

CHI from trauma is generally blunt trauma in origin. Looking at the diagram below I would expect to see both unilateral OR bilateral depending on the patient.

https://tse1.mm.bing.net/th?id=OIP....EsDH&w=147&h=105&c=8&rs=1&qlt=90&pid=3.1&rm=2

 

[Kevinf]

CHI from trauma is generally blunt trauma in origin. Looking at the diagram below I would expect to see both unilateral OR bilateral depending on the patient.

https://tse1.mm.bing.net/th?id=OIP....EsDH&w=147&h=105&c=8&rs=1&qlt=90&pid=3.1&rm=2

Hang on... need to get my microscope out!

 

[VentMonkey]

Yes? No? Maybe so? @vc85 what exactly are you getting at, or trying to learn?

In short you can expect to see any, and/ or all of the above. Sure, extremely pinpoint pupils may lead you to think perhaps a pontine bleed in the presence of a suspected closed head injury, but really pupillary changes can vary and aren’t held to one specific type of closed head injury, be it atraumatic or traumatic.

This same theory may very well hold true for things such as lucid intervals, erratic respiratory rates, Cushing’s Reflexes, thunderclap headaches etc. These are all—more or less—pointers in a suspected right direction until furthers tests, and specialists can confirm the diagnosis.

 

[MSDeltaFlt]

Hang on... need to get my microscope out!

Don't judge. I'm not tech savy.