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학습 자료 둘러보기 →A unilateral, fixed, and dilated pupil is a localizing sign of uncal herniation. The uncus compresses cranial nerve III, causing loss of parasympathetic tone and unopposed sympathetic dilation. This finding demands immediate notification of the provider.
This sign localizes an expanding mass to the ipsilateral cerebral hemisphere. It is a more specific and later finding than changes in the Glasgow Coma Scale (GCS) and signals imminent brainstem compression.
Do not confuse a sluggish bilateral response with a fixed unilateral pupil. A fixed and dilated pupil is a pre-terminal sign. Prepare for emergency interventions like hyperventilation or mannitol administration while awaiting definitive surgical decompression.
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