Cargando…

Atypical Pupil Reactions in Brain Dead Patients

Background: During routine diagnosis of brain death, changes in pupil diameter in response to the stimulation of peripheral nerves are sometimes observed. For example, pupillary dilation after diagnosed brain death is described in the literature as the ciliospinal reflex. However, pupil constriction...

Descripción completa

Detalles Bibliográficos
Autores principales: Sołek-Pastuszka, Joanna, Zegan-Barańska, Małgorzata, Biernawska, Jowita, Sawicki, Marcin, Iwańczuk, Waldemar, Chełstowski, Kornel, Bohatyrewicz, Romuald, Dąbrowski, Wojciech, Kojder, Klaudyna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8466677/
https://www.ncbi.nlm.nih.gov/pubmed/34573214
http://dx.doi.org/10.3390/brainsci11091194
_version_ 1784573202544984064
author Sołek-Pastuszka, Joanna
Zegan-Barańska, Małgorzata
Biernawska, Jowita
Sawicki, Marcin
Iwańczuk, Waldemar
Chełstowski, Kornel
Bohatyrewicz, Romuald
Dąbrowski, Wojciech
Kojder, Klaudyna
author_facet Sołek-Pastuszka, Joanna
Zegan-Barańska, Małgorzata
Biernawska, Jowita
Sawicki, Marcin
Iwańczuk, Waldemar
Chełstowski, Kornel
Bohatyrewicz, Romuald
Dąbrowski, Wojciech
Kojder, Klaudyna
author_sort Sołek-Pastuszka, Joanna
collection PubMed
description Background: During routine diagnosis of brain death, changes in pupil diameter in response to the stimulation of peripheral nerves are sometimes observed. For example, pupillary dilation after diagnosed brain death is described in the literature as the ciliospinal reflex. However, pupil constriction creates diagnostic doubts. Objective: The pupillometric analysis of pupil response to stimulation of the cervicothoracic spinal cord in patients with diagnosed brain death. Methods: Instrumental tests to confirm the arrest of cerebral circulation were performed in 30 adult subjects (mean age 53.5 years, range 26–75 years) with diagnosed brain death. In addition, a pupillometer was used to measure the change in pupil diameter in response to neck flexion. Intervention: Flexion of the neck and measuring the response in change of the pupil with the use of the pupillometer. Results: The change in the pupil was observed in the examined group of patients. Difference in pupil size ≥ 0.2 mm was observed in 14 cases (46%). In five cases (17%), pupil constriction was found (from 0.2 to 0.7 mm). Measurement error was +/− 0.1 mm. Conclusions: Both pupillary constriction and dilatation may occur due to a ciliospinal reflex in patients with brain death. This phenomenon needs further research in order to establish its pathophysiology.
format Online
Article
Text
id pubmed-8466677
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-84666772021-09-27 Atypical Pupil Reactions in Brain Dead Patients Sołek-Pastuszka, Joanna Zegan-Barańska, Małgorzata Biernawska, Jowita Sawicki, Marcin Iwańczuk, Waldemar Chełstowski, Kornel Bohatyrewicz, Romuald Dąbrowski, Wojciech Kojder, Klaudyna Brain Sci Study Protocol Background: During routine diagnosis of brain death, changes in pupil diameter in response to the stimulation of peripheral nerves are sometimes observed. For example, pupillary dilation after diagnosed brain death is described in the literature as the ciliospinal reflex. However, pupil constriction creates diagnostic doubts. Objective: The pupillometric analysis of pupil response to stimulation of the cervicothoracic spinal cord in patients with diagnosed brain death. Methods: Instrumental tests to confirm the arrest of cerebral circulation were performed in 30 adult subjects (mean age 53.5 years, range 26–75 years) with diagnosed brain death. In addition, a pupillometer was used to measure the change in pupil diameter in response to neck flexion. Intervention: Flexion of the neck and measuring the response in change of the pupil with the use of the pupillometer. Results: The change in the pupil was observed in the examined group of patients. Difference in pupil size ≥ 0.2 mm was observed in 14 cases (46%). In five cases (17%), pupil constriction was found (from 0.2 to 0.7 mm). Measurement error was +/− 0.1 mm. Conclusions: Both pupillary constriction and dilatation may occur due to a ciliospinal reflex in patients with brain death. This phenomenon needs further research in order to establish its pathophysiology. MDPI 2021-09-10 /pmc/articles/PMC8466677/ /pubmed/34573214 http://dx.doi.org/10.3390/brainsci11091194 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Study Protocol
Sołek-Pastuszka, Joanna
Zegan-Barańska, Małgorzata
Biernawska, Jowita
Sawicki, Marcin
Iwańczuk, Waldemar
Chełstowski, Kornel
Bohatyrewicz, Romuald
Dąbrowski, Wojciech
Kojder, Klaudyna
Atypical Pupil Reactions in Brain Dead Patients
title Atypical Pupil Reactions in Brain Dead Patients
title_full Atypical Pupil Reactions in Brain Dead Patients
title_fullStr Atypical Pupil Reactions in Brain Dead Patients
title_full_unstemmed Atypical Pupil Reactions in Brain Dead Patients
title_short Atypical Pupil Reactions in Brain Dead Patients
title_sort atypical pupil reactions in brain dead patients
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8466677/
https://www.ncbi.nlm.nih.gov/pubmed/34573214
http://dx.doi.org/10.3390/brainsci11091194
work_keys_str_mv AT sołekpastuszkajoanna atypicalpupilreactionsinbraindeadpatients
AT zeganbaranskamałgorzata atypicalpupilreactionsinbraindeadpatients
AT biernawskajowita atypicalpupilreactionsinbraindeadpatients
AT sawickimarcin atypicalpupilreactionsinbraindeadpatients
AT iwanczukwaldemar atypicalpupilreactionsinbraindeadpatients
AT chełstowskikornel atypicalpupilreactionsinbraindeadpatients
AT bohatyrewiczromuald atypicalpupilreactionsinbraindeadpatients
AT dabrowskiwojciech atypicalpupilreactionsinbraindeadpatients
AT kojderklaudyna atypicalpupilreactionsinbraindeadpatients