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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10904
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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after an accident 2 days ago wherby my 18 yr old son broke

Resolved Question:

after an accident 2 days ago wherby my 18 yr old son broke his clavical and has a compression fracture of his T7 vertebrae, he now has numbness in his arm and one pupil enlarged. what could this be from - he received a knock to his head and had quite a large bump right on the top right hand corner of his head
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Rick replied 6 years ago.

Dr. Rick :

Hi. I can help you today.

JACUSTOMER-g7y5kcwb- :

as per my question, should i be concerned

Dr. Rick :

Is one pupil smaller then the other, and on which side is the smaller pupil? Is the eyelid on the side of the smaller pupil a little bit droopy?

JACUSTOMER-g7y5kcwb- :

his smaller pupil is on the damaged arm

Dr. Rick :

can you notice a slight droopyness in the upper lid of the smaller pupil side? It may not be much. Look at the arc of the top of the colored part of his eye (iris) for comparison

Dr. Rick :

What type of accident was it?

JACUSTOMER-g7y5kcwb- :

he has a lazy eye defect from birth so hard to say he was snowboarding down a pretty steep hill and collided with a tree, pretty big impact

Dr. Rick :

Also, not on the topic, but I have good friends in Londonderry.....

Dr. Rick :

Well, the most important thing to rule out in his case is a horner's syndrome from Carotid artery dissection. Other things can also cause anisocoria (different pupil size) secondary to trauma like this, things such as iritis, trauma to the iris muscle itself etc. But in your son's case it is very important that carotid artery dissection be considered and ruled out.

Dr. Rick :

It can be evaluated by an carotid doppler exam, MRI or carotid angiogram, the latter being the "gold standard" for diagnosing this condition.

JACUSTOMER-g7y5kcwb- :

what are the reprecussions of the carotid artery dissection and would it not have been noticed by now,

Dr. Rick :

It can take time to develop; the dangers are severe: stroke, vision loss and other bad things. I don't want you to panic. Remember, I can not examine your son and am only going on what you are telling me. But, in this case I believe, at the minimum, a call to his doctor is needed and, at most, a visit to the ER.

JACUSTOMER-g7y5kcwb- :

thank u very much

Dr. Rick :

my pleasure. I hope your son heals quickly.

Dr. Rick :

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Expert:  Dr. Rick replied 6 years ago.
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Expert:  Dr. Rick replied 6 years ago.
Here is a link to an article you might find informative:

http://en.wikipedia.org/wiki/Carotid_artery_dissection
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