• J Clin Neuroophthalmol · Mar 1989

    Case Reports

    Mesencephalic hemorrhage and unilateral pupillary deficit.

    • A Shuaib, G Israelian, and M A Lee.
    • Foothills Hospital, Calgary, Alberta, Canada.
    • J Clin Neuroophthalmol. 1989 Mar 1; 9 (1): 47-9.

    AbstractAn isolated dilated and fixed pupil in the absence of other neurological dysfunction usually suggests ciliary ganglion dysfunction or direct pharmacological blockade of the parasympathetic fibers to the pupil. A unilateral dilated pupil as a manifestation of a mesencephalic hemorrhage has not, to our knowledge, previously been reported. We now describe a 35-year-old woman who had a headache and a dilated and nonreactive right pupil. A cranial computed tomography scan showed a small hemorrhage in the midbrain, and a cerebral angiogram was normal. Mesencephalic hemorrhage should be considered in the differential diagnosis of an isolated dilated pupil.

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