title: Paradoxical fixed dilatation of the contralateral pupil as a false-localizing sign in intraparenchymal frontal hemorrhage.
abstract: Unilateral fixed pupillary dilatation represents an important clinical sign of transtentorial herniation of an ipsilateral mass lesion. Rarely the contralateral pupil is affected to produce a false-localizing sign. Two cases of this paradoxical contralateral fixed pupillary dilatation involving intra-axial lesions have been reported. We report a case of a 33-year-old man with a left frontal intraparenchymal hemorrhage who developed a false localizing fixed dilatation of his right pupil, which resolved after craniotomy and evacuation of the clot. The possible mechanisms of contralateral third nerve palsy are discussed.
authors.affiliation: Department of Neurosurgery, The Canberra Hospital, PO Box 11, Woden, ACT 2606, Australia. cchung@med.usyd.edu.au
authors.forename: K H Carlos
authors.initials: KH
authors.lastname: Chung
authors.forename: K Nadana
authors.initials: KN
authors.lastname: Chandran
mesh_terms: D000328:Adult; D015875:Anisocoria / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D004292:Dominance, Cerebral / Q000502:physiology*; D005625:Frontal Lobe / Q000293:injuries* / Q000601:surgery; D015600:Glasgow Coma Scale; D016489:Head Injuries, Closed / Q000175:diagnosis* / Q000601:surgery; D006406:Hematoma / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D009460:Neurologic Examination; D014057:Tomography, X-Ray Computed