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I serially examined the pupil opposite the one already enlarged from transtentorial herniation in 13 patients.The main abnormalities, stereotyped in most patients,were an initially diminished light reaction with a 2.5-to 4-mm-diameter pupil,followed by slight reduction in size,and then reenlargement to greater than original size,all with preserved roundness.Subsequent deterioration varied among patients,but a transitional oval shape was infrequent and oculomotor function was preserved until both pupils were enlarged and fixed.Once the pupil on the side of a mass enlarges,heralding herniation,subsequent deterioration can be appreciated through changes in reactivity and size of the opposite pupil. |
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pupil pupil,abnormality in neurologic disorders pupil,dilated and fixed,unilateral pupil,light reflex of pupil,light reflex,abnormal pupil,oval uncal herniation
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