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November 13, 1972

Unilateral Mydriasis and Headache

Author Affiliations

San Mateo, Calif

JAMA. 1972;222(7):838. doi:10.1001/jama.1972.03210070068028

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To the Editor.—  The question on unilateral dilatation of the pupil and headache (221:1171, 1972) seems insufficiently answered. The most serious important cause that comes to mind is an intracranial aneurysm! I agree that other conditions (migraine, glaucoma) are more likely, but specific mention of aneurysm, a potentially fatal disease, cannot be omitted in the face of such a classical sign and symptom. Of course, this possibility could have been ruled out, but without knowing the extent of neuroophthalmic examination of this patient, I feel that this is too dangerous an assumption to allow.