Acute Crit Care.  2018 Feb;33(1):57-60. 10.4266/acc.2017.00213.

Implication of Neurological Pupil Index for Monitoring of Brain Edema

Affiliations
  • 1Department of Neurology, Seoul National University Hospital, Seoul, Korea. sangbai1378@gmail.com
  • 2Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Korea.

Abstract

No abstract available.


MeSH Terms

Brain Edema*
Brain*
Pupil*

Figure

  • Figure 1. Serial pupillometer parameters and brain CT of the patient. (A) Serial pupillometer parameters of the patient. (B-D) Serial brain CTs of the patient. Serial changes of pupillometer parameters: on hospital day (HD) 4, bilateral NPi value decreased and neurological symptom was aggravated combining increased midline shifting (A). Cerebral edema was gradually decreased during TTM and pupillometer parameters were stably maintained until HD 10. On HD 11, bilateral NPIs suddenly decreased below 2 and brain CT scan showed that brain edema was aggravated (midline shift 13 mm) (C). TTM was restarted and maintained until HD 19 with continuous pupillometer monitoring. HD: hospital day; NICU: neurological intensive care unit; TTM: targeted temperature management; Rt: right; NPi: Neurological Pupil Index; CV: constriction velocity; Lat: latency; Lt: left; GCS: Glasgow Coma Scale; CT: computed tomography.


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