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학습 자료 둘러보기 →A unilateral fixed and dilated pupil (8mm and non-reactive) is a late, critical sign of oculomotor nerve (CN III) compression from uncal herniation. This signifies a life-threatening rise in intracranial pressure (ICP) requiring immediate intervention.
The parasympathetic fibers controlling pupil constriction run on the outer surface of CN III. As the brain herniates, these fibers are compressed, causing parasympathetic paralysis and unopposed sympathetic dilation. This finding localizes the lesion to the ipsilateral side of the mass.
A "blown pupil" is a pre-terminal sign. Do not wait for bilateral dilation or a complete loss of consciousness. Notify the provider immediately and prepare for interventions to rapidly lower ICP, such as hyperosmolar therapy or emergency surgery.
학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요.