Neurologist Versus Machine: Is the Pupillometer Better than the Naked Eye in Detecting Pupillary Reactivity

Christopher L. Kramer, Alejandro Rabinstein, Eelco F M Wijdicks, Sara E. Hocker

Research output: Contribution to journalArticle

13 Scopus citations


Background: A 62-year-old man with severe traumatic brain injury developed postsurgical anisocoria in which there was a discrepancy between pupillometer and manual testing.

Methods: Case report.

Results: The patient’s larger pupil was read as unreactive by the pupillometer but constricted 1 mm over 7–9 s of continuous light stimulation.

Conclusions: While pupillometry assessment is a valuable adjunct to the manual pupillary assessment, this case demonstrates that nonreactive pupils read on the pupillometer should be confirmed with the manual examination because it can miss very slowly reacting pupils.

Original languageEnglish (US)
Pages (from-to)309-311
Number of pages3
JournalNeurocritical Care
Issue number2
StatePublished - Jan 1 2014



  • Brain death
  • Neurocritical care
  • Neurological examination
  • Pupillary reactivity
  • Pupillometer
  • Uncal herniation

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine
  • Medicine(all)

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