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nadiabarati

06/25/06 - 07:50 PM             #1

After nearly drowning, an 82-year-old man suffers from severe hypoxia with resulting severe brain edema. This edema leads to raised intracranial pressure. When the pressure exceeds 200 mmHg, the medial temporal lobe begins to be compressed against the tentorium cerebelli. What is typically the first sign of such compression?

A. Anisocoria contralateral to compression

B. Anisocoria ipsilateral to compression

C. Both pupils 5–6 mm and fixed

D. External oculomotor ophthalmoplegia

E. This condition has no effect on the eyes



robin082006
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06/25/06 - 08:03 PM             #2

This patient may have uncal herniation.

Ipsilateral CN III may be affected---> ipsilateral dilated pupil and ipsilateral ptosis.

Only choice B and D may be correct, but these both choices are ambiguous.

I prefer choice B


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nadiabarati

06/25/06 - 08:46 PM             #3

agree B, but still strange! dilated is better than anisocoria!

sridevibandaru24
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06/25/06 - 11:51 PM             #4

yeah! it sounds like B

jedw
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06/26/06 - 11:03 AM             #5

B seems ok, but anisocoria means unequal pupils, so ipsilateral means it's dilated or narrowed? smiling face they should avoid such uncertainty

waqastariq

06/26/06 - 12:51 PM             #6

ipsilateral anisocoria
anisocoria is what I know ...the irregular pupil ... so only the one affected becomes irregular ...its not about dilated / narrowed... smiling face


waqastariq

06/26/06 - 12:52 PM             #7

option B

NE
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10/30/06 - 04:04 PM             #8

I never heard about anisocoria ipsilateral or contralateral.Anisocoria = difference in pupil size.
I supposed it could be C- it is a great intracranial pressure ( The normal pressure for is 15 mm/Hg or 150 mm - 200 mm of water).







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