Pritz M B
Department of Neurological Surgery, California College of Medicine, University of California Irvine Medical Center, Orange.
Surg Neurol. 1994 Apr;41(4):281-2; discussion 283. doi: 10.1016/0090-3019(94)90173-2.
Pupillary changes attributed to intracisternal papaverine injection were observed in three patients who underwent pterional craniotomy and clipping of a supratentorial aneurysm in which the oculomotor nerve was not manipulated. A fixed and dilated pupil on the side of the craniotomy lasted 2 to 4 hours after intracisternal papaverine instillation. These observations suggest that a dilated, nonreactive pupil subsequent to an uncomplicated pterional craniotomy for aneurysm, in which oculomotor nerve trauma has not occurred, may not be an ominous finding but may represent a transient phenomenon related to intracisternal papaverine injection.
