Quantitative pupillometry in patients with traumatic brain injury and loss of consciousness: A prospective pilot study

Jeffrey I. Traylor, Tarek Y. El Ahmadieh, Nicole M. Bedros, Nadeem Al Adli, Sonja E. Stutzman, Aardhra M. Venkatachalam, Mark N. Pernik, C. Munro Collum, Peter M. Douglas, Venkatesh Aiyagari, Carlos A. Bagley, Dai Wai M. Olson, Salah G. Aoun

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Loss of consciousness (LOC) is a hallmark feature in Traumatic Brain Injury (TBI), and a strong predictor of outcomes after TBI. The aim of this study was to describe associations between quantitative infrared pupillometry values and LOC, intracranial hypertension, and functional outcomes in patients with TBI. Methods: We conducted a prospective study of patients evaluated at a Level 1 trauma center between November 2019 and February 2020. Pupillometry values including the Neurological Pupil Index (NPi), constriction velocity (CV), and dilation velocity (DV) were obtained. Results: Thirty-six consecutive TBI patients were enrolled. The median (range) age was 48 (range 21–86) years. The mean Glasgow Coma Scale score on arrival was 11.8 (SD = 4.0). DV trichotomized as low (<0.5 mm/s), moderate (0.5–1.0 mm/s), or high (>1.0 mm/s) was significantly associated with LOC (P = .02), and the need for emergent intervention (P < .01). No significant association was observed between LOC and NPi (P = .16); nor between LOC and CV (P = .07). Conclusions: Our data suggests that DV, as a discrete variable, is associated with LOC in TBI. Further investigation of the relationship between discrete pupillometric variables and NPi may be valuable to understand the clinical significance of the pupillary light reflex findings in acute TBI.

Original languageEnglish (US)
Pages (from-to)88-92
Number of pages5
JournalJournal of Clinical Neuroscience
Volume91
DOIs
StatePublished - Sep 2021

Keywords

  • Concussion
  • Craniectomy
  • Glasgow coma scale
  • Neurological pupil index
  • Pupillometry
  • Traumatic brain injury

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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