Although millions of children sustain concussions each year, a rapid and objective test for concussion has remained elusive. The aim of this study was to investigate quantitative pupillometry in pediatric patients in the acute, postinjury setting. This was a prospective case-control study of concussed patients presenting to the emergency department within 72 hours of injury. Pupillary measurements were gathered using NeurOptics’ PLR 3000; evaluation included a symptom checklist and neurocognitive assessment. Data were analyzed using descriptive statistics and regression models. A total of 126 participants were enrolled. One significant difference in pupillometry between concussed and control participants was found: left minimum pupil diameter in 12- to 18 year-olds ( = 0.02). Models demonstrating odds of a concussion revealed significant associations for time to 75% recovery (T75) of the left pupil in five- to 11-year-olds and average dilation velocity of the left pupil in 12- to 18-year-olds ( = 0.03 and 0.02 respectively). Models predicting symptom improvement showed one significant association: percent change of the right pupil in five-to-11-year-olds ( = 0.02). Models predicting neurocognitive improvement in 12- to 18-year-olds demonstrated significant association in T75 in the left pupil for visual memory, visual motor processing speed, and reaction time ( = 0.002, = 0.04, = 0.04). The limited statistically significant associations found in this study suggest that pupillometry may not be useful in pediatrics in the acute postinjury setting for either the diagnosis of concussion or to stratify risk for prolonged recovery.

中文翻译：

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定量瞳孔测量在小儿急性损伤后脑震荡中的评估

尽管每年有数百万儿童遭受脑震荡，但快速、客观的脑震荡测试仍然难以实现。本研究的目的是研究急性损伤后儿童患者的定量瞳孔测量。这是一项前瞻性病例对照研究，对象是受伤后 72 小时内到急诊科就诊的脑震荡患者。使用 NeurOptics 的 PLR 3000 收集瞳孔测量值；评估包括症状检查表和神经认知评估。使用描述性统计和回归模型对数据进行分析。共有 126 名参与者参加。发现脑震荡参与者和对照组参与者之间的瞳孔测量存在显着差异：12 至 18 岁儿童的左侧最小瞳孔直径 (= 0.02)。证明脑震荡几率的模型显示，5 至 11 岁儿童左瞳孔恢复 75% 的时间 (T75) 与 12 至 18 岁儿童左瞳孔平均扩张速度存在显着相关性 (=分别为 0.03 和 0.02）。预测症状改善的模型显示出一种显着的关联：5 至 11 岁儿童右瞳孔的百分比变化 (= 0.02)。预测 12 至 18 岁青少年神经认知改善的模型表明，左瞳孔 T75 与视觉记忆、视觉运动处理速度和反应时间显着相关 (= 0.002，= 0.04，= 0.04)。本研究中发现的有限的统计显着关联表明，瞳孔测量在急性损伤后的儿科中可能无法用于诊断脑震荡或对长期恢复的风险进行分层。