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The pupils in brainstem-dead patients are classically fixed and dilated. We present a case of a brainstem-dead patient whose pupils displayed persistent asynchronous pupillary constriction and dilatation independent of external physical stimuli. Central causes for the phenomenon were excluded leaving an unexplained peripheral cause as the most likely explanation. Early recognition of this phenomenon prevents delay in the diagnosis of brainstem death, lessening to some extent the distress for the family, and facilitating earlier organ donation and allowing the better use of resources.

Type

Journal article

Journal

Br J Anaesth

Publication Date

05/2001

Volume

86

Pages

717 - 720

Keywords

Adult, Brain Death, Brain Stem, Female, Hematoma, Subdural, Acute, Humans, Reflex, Pupillary