Starry Eye

A 73-year-old female with a past medical history of stroke, hypertension, end stage renal disease on hemodialysis presents to the emergency department for altered mental status and slurred speech. On physical examination, she had a right pupillary defect in a star-like pattern with initial concern for a blown pupil (see image) raising suspicion for acute stroke. Her initial blood pressure was 230/110 mmHg and neuroimaging were unremarkable for stroke. She was admitted for hypertensive emergency.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research