Quantitative Pupillometry: Not a Clear Predictor of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage

[...]like many observed phenomena, accurate identification of nuanced pupillary abnormalities requires highly trained assessors, which can limit the reliability of the measurement [2, 3] and its full potential as a noninvasive longitudinal biomarker. [5] treated NPi as a dichotomous rather than a continuous variable, which may have more clinical use but may not capture a more nuanced association. [...]the frequency with which pupil observations were taken (every 8 h) may not have been sufficient to capture pupil abnormalities that occur close in time to DCI. [...]although the authors hypothesized that the pupillary light reflex could be affected by ischemic injury due to DCI after SAH, the mechanism by which the hypothesized decreased reactivity is unclear.