Fixed and dilated pupils suggest which condition?

Fixed and dilated pupils suggest which condition?

• A. Brain Death
• B. Opiate poisoning
• C. Increased ICP
• D. Stroke

Answer: (A)

Pupillary light reflex reflects brainstem function. When both pupils are fixed and dilated and do not react to light, it indicates a loss of brainstem reflexes consistent with brain death. Opiate poisoning produces pinpoint, constricted pupils, not fixed dilation, so that pattern doesn’t fit. Increased intracranial pressure can lead to dilated pupils if a herniation compresses the oculomotor nerve, but they are not necessarily fixed and nonreactive in all cases. A stroke can affect pupil size, but fixed and dilated pupils are a stronger sign of extensive brainstem failure and brain death.

Pupillary light reflex reflects brainstem function. When both pupils are fixed and dilated and do not react to light, it indicates a loss of brainstem reflexes consistent with brain death. Opiate poisoning produces pinpoint, constricted pupils, not fixed dilation, so that pattern doesn’t fit. Increased intracranial pressure can lead to dilated pupils if a herniation compresses the oculomotor nerve, but they are not necessarily fixed and nonreactive in all cases. A stroke can affect pupil size, but fixed and dilated pupils are a stronger sign of extensive brainstem failure and brain death.