{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T10:55:43Z","timestamp":1794048943895,"version":"4.8.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,7,15]],"date-time":"2023-07-15T00:00:00Z","timestamp":1689379200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,15]],"date-time":"2023-07-15T00:00:00Z","timestamp":1689379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>New-onset anisocoria is an important clinical clue to life-threatening intracranial injury. Anisocoria alone without impairment of extraocular muscles is a rare presentation of moderate traumatic brain injury (TBI).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 79-year-old woman was transported to hospital soon after falling off a bicycle. Glasgow Coma Scale score on arrival was 11 (E3V3M5). On examination at admission, she was found to be drowsy. Bruising was seen around the right eye and pupil diameters differed (right, 4.5 mm; left, 3.0 mm; both reactive to light). Computed tomography of the head revealed hemorrhagic contusion in the left temporal lobe and left pretectal area of the midbrain, right clavicular fracture, and pulmonary contusion with fractures of the 3rd and 4th ribs. Magnetic resonance imaging confirmed hemorrhagic contusion of the midbrain. The patient achieved full recovery of motor and mental functions with conservative treatment and was discharged on hospital day 17.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We encountered a case of anisocoria without major extraocular muscle impairment due to moderate TBI with midbrain contusion.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12883-023-03331-2","type":"journal-article","created":{"date-parts":[[2023,7,15]],"date-time":"2023-07-15T06:01:34Z","timestamp":1689400894000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Anisocoria without extraocular muscle impairment due to moderate traumatic brain injury with midbrain contusion: a case report"],"prefix":"10.1186","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1461-7031","authenticated-orcid":false,"given":"Koshi","family":"Ota","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Kobata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshisuke","family":"Hamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saki","family":"Mizutani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terunari","family":"Okuyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanna","family":"Ota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuriko","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Takasu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,15]]},"reference":[{"issue":"2","key":"3331_CR1","doi-asserted-by":"publisher","first-page":"E143","DOI":"10.1097\/CCM.0000000000005272","volume":"50","author":"BR Prescott","year":"2022","unstructured":"Prescott BR, Saglam H, Duskin JA, et al. Anisocoria and poor pupil reactivity by quantitative pupillometry in patients with intracranial pathology. Crit Care Med. 2022;50(2):E143-53. https:\/\/doi.org\/10.1097\/CCM.0000000000005272.","journal-title":"Crit Care Med"},{"issue":"4","key":"3331_CR2","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1016\/j.emc.2016.06.016","volume":"34","author":"JS Huff","year":"2016","unstructured":"Huff JS, Austin EW. Neuro-ophthalmology in emergency medicine. Emerg Med Clin North Am. 2016;34(4):967\u201386. https:\/\/doi.org\/10.1016\/j.emc.2016.06.016.","journal-title":"Emerg Med Clin North Am"},{"issue":"1","key":"3331_CR3","doi-asserted-by":"publisher","first-page":"234","DOI":"10.3171\/2017.3.JNS162720","volume":"129","author":"A Vedantam","year":"2018","unstructured":"Vedantam A, Robertson CS, Gopinath SP. Clinical characteristics and temporal profile of recovery in patients with favorable outcomes at 6 months after severe traumatic brain injury. J Neurosurg. 2018;129(1):234\u201340. https:\/\/doi.org\/10.3171\/2017.3.JNS162720.","journal-title":"J Neurosurg"},{"issue":"3","key":"3331_CR4","doi-asserted-by":"publisher","first-page":"CNC36","DOI":"10.2217\/cnc-2016-0029","volume":"2","author":"KJ Ciuffreda","year":"2017","unstructured":"Ciuffreda KJ, Joshi NR, Truong JQ. Understanding the effects of mild traumatic brain injury on the pupillary light reflex. Concussion. 2017;2(3):CNC36. https:\/\/doi.org\/10.2217\/cnc-2016-0029.","journal-title":"Concussion"},{"issue":"4","key":"3331_CR5","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.3171\/2017.10.JNS17352","volume":"130","author":"MC Dewan","year":"2019","unstructured":"Dewan MC, Rattani A, Gupta S, et al. Estimating the global incidence of traumatic brain injury. J Neurosurg. 2019;130(4):1080\u201397. https:\/\/doi.org\/10.3171\/2017.10.JNS17352.","journal-title":"J Neurosurg"},{"issue":"3\u20134","key":"3331_CR6","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1007\/s11102-006-6041-5","volume":"8","author":"J Le\u00f3n-Carri\u00f3n","year":"2005","unstructured":"Le\u00f3n-Carri\u00f3n J, Dom\u00ednguez-Morales M del R, Barroso y Mart\u00edn JM, Murillo-Cabezas F. Epidemiology of traumatic brain injury and subarachnoid hemorrhage. Pituitary. 2005;8(3\u20134):197\u2013202. https:\/\/doi.org\/10.1007\/s11102-006-6041-5.","journal-title":"Pituitary"},{"issue":"3","key":"3331_CR7","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/S0303-8467(00)00095-0","volume":"102","author":"Y Shibata","year":"2000","unstructured":"Shibata Y, Matsumura A, Meguro K, Narushima K. Differentiation of mechanism and prognosis of traumatic brain stem lesions detected by magnetic resonance imaging in the acute stage. Clin Neurol Neurosurg. 2000;102(3):124\u20138. https:\/\/doi.org\/10.1016\/S0303-8467(00)00095-0.","journal-title":"Clin Neurol Neurosurg"},{"issue":"1","key":"3331_CR8","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/0002-9394(87)90296-0","volume":"104","author":"BL Lam","year":"1987","unstructured":"Lam BL, Thompson HS, Corbett JJ. The prevalence of simple anisocoria. Am J Ophthalmol. 1987;104(1):69\u201373. https:\/\/doi.org\/10.1016\/0002-9394(87)90296-0.","journal-title":"Am J Ophthalmol"},{"issue":"1","key":"3331_CR9","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1186\/s12883-022-02801-3","volume":"22","author":"CM Privitera","year":"2022","unstructured":"Privitera CM, Neerukonda SV, Aiyagari V, et al. A differential of the left eye and right eye neurological pupil index is associated with discharge modified Rankin scores in neurologically injured patients. BMC Neurol. 2022;22(1):273. https:\/\/doi.org\/10.1186\/s12883-022-02801-3.","journal-title":"BMC Neurol"},{"issue":"10","key":"3331_CR10","doi-asserted-by":"publisher","first-page":"614","DOI":"10.7887\/jcns.28.614","volume":"28","author":"E Suehiro","year":"2019","unstructured":"Suehiro E, Ishihara H, Fujiyama Y, et al. Corresponding to geriatric traumatic brain injury in patients taking antithrombotic agent. Japanese J Neurosurg. 2019;28(10):614\u201320. https:\/\/doi.org\/10.7887\/jcns.28.614.","journal-title":"Japanese J Neurosurg"},{"issue":"3","key":"3331_CR11","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1272\/jnms.JNMS.2021_88-404","volume":"88","author":"S Yokobori","year":"2021","unstructured":"Yokobori S, Saito K, Sasaki K, et al. Treatment of geriatric traumatic brain injury: a nationwide cohort study. J Nippon Med Sch. 2021;88(3):194\u2013203. https:\/\/doi.org\/10.1272\/jnms.JNMS.2021_88-404.","journal-title":"J Nippon Med Sch"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-023-03331-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-023-03331-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-023-03331-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,15]],"date-time":"2023-07-15T06:01:50Z","timestamp":1689400910000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcneurol.biomedcentral.com\/articles\/10.1186\/s12883-023-03331-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,15]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["3331"],"URL":"https:\/\/doi.org\/10.1186\/s12883-023-03331-2","relation":{},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,15]]},"assertion":[{"value":"1 October 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 July 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"was not required for this case report. Written informed consent to participate was obtained from the patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"We obtained verbal and written informed consent from the patient to publish this case.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"270"}}