No return of pupillary function: relationship of NPi scores, pupillary asymmetry, and brain images. Patient three is a 12-year-old helmeted male motorcross cyclist involved in a crash. Initial CT studies (C, D) revealed a left-sided basal ganglia hemorrhage. Initial IP NPi scores (A, time 0 months) and IP size measurements (B, time 0 months) show some asymmetry between the pupils and no pupillary function on the right side. IP assessments from follow-up appointments (A, B, time 4-15 months) indicate some return of pupillary symmetry between both pupils and nominal increases in NPi values for the right pupil by month four. Post-contrast MRI studies at six weeks (F) capture enhancement of the third nerve (see white arrow) at the location where the nerve leaves the midbrain. Non-contrasted MRI studies (E) show the right intact nerve at six weeks. Note: the time = 0 months represents the average of hourly measurements that were done during the first week that the patient was in the ICU. The measurements taken at the other time points were done in the NeuroTrauma clinic and represent an average of three measurements.