Figure 2

Partial return of pupillary function: relationship of NPi scores, pupillary asymmetry, and brain images. Patient one is a 43-year-old unhelmeted female bicyclist involved in a collision with a stationary automobile. Initial CT studies (C, D) revealed a left-frontal intracerebral contusion. Initial IP NPi scores (A, time 0 months) and IP size measurements (B, time 0 months) show significant third nerve dysfunction on the right side and asymmetry between the pupils. IP assessments from follow-up appointments (A, B, time 5-15 months) indicate a return of pupillary symmetry between both pupils and slow, incremental increases in NPi scores for the right pupil. Non-contrasted MRI studies at three months show the right intact third nerve (E, see white arrow) and post-contrast MRI studies at three months (F) demonstrate enhancement of the third nerve (see white arrow) at the location where the nerve leaves the midbrain. Note: the time = 0 months represents the average of hourly measurements that were done during the first week that the patient was in the NeuroTrauma ICU. The measurements taken at the other time points were done in the NeuroTrauma clinic and represent an average of three measurements.