Brain herniation and eye movement

Nurses General Nursing

Published

I have been trying to look up the name of this eye movement, but have not had any luck. Any of you that have experience with this, please chime in.

Pt had massive global stroke, younger 50ish. I was reading the notes before I got this transfer and it stated that there was no herniation as of yet, but without surgery the MD's thought that it was likely that the brain would herniate.

When I recieved the pt, her eyes were moving like you were reading a book. It didn't matter if you opened her eye lids or if the lids were closed, her eyes were still moving back and forth like reading a book. I know this is a sign of brain damage, but would like to know the technical term for it if anyone knows what I am talking about.

Thanks!

Specializes in MED/SURG STROKE UNIT, LTC SUPER., IMU.

Thank you Esme! Everyone was a little freaked out by the eye movement last night and what that meant to the nursing care. We knew what was happening, but none of us had actually seen someone's eyes do that before.

Very, Very sad case.

For more search results, you might also look at periodic alternating gaze.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
wow esme, that was a nice comprehensive review!

Thanks....I love my critical care....:D

Specializes in ICU, Telemetry.
Everything that I am looking up mentions nystamus or abscent upward movement of the eye, but nothing that really describes what I was seeing.

Nerdtonurse, what was the diagnosis with your pt?

Approximately 20 ft fall out of deer stand and crossbow fired into the back of the pt's head. It's been a while, but what I remember now is that the cerebellum took a hit as the bolt transversed the brain. He made it to us, breathing about 4x minute, eyes going crazy, herniating, bad stuff all around, had fractured pelvis, leg, ribs, etc.. I assumed the rapid eye motions were the equivalent of a stroke victim "looking" at the stroke site, as this guy's brain was tore up. I don't remember the exact areas, but if "Oopsied beyond all repair" was a Nanda diagnosis, this guy would have gotten it.

The only thing that should come out of a nose is air, snot or an NG tube.

and BTW, I wish I worked with Esme!

actually her head was perfectly stationary. I thought that doll's eye reflex was only when you turned the pt's head and their eyes still looked forward rather than the normal responce which is to turn the eyes to the opposite side of the way the head is turned.

I think that I found my answer. From what I was reading it is Ping Pong gaze and when it stops is when the herniation reaches the brain stem and the pts die soon afterward.

oh ewwww. I think I just reached my gross out point. I have never seen anything like this, my few neuro pt's went to surg or recovered to some extent. Still glad for the info. thanks.

If I remember right, caloric testing can also induce vomiting in some folks.

Specializes in MED/SURG STROKE UNIT, LTC SUPER., IMU.

I wish I worked with Esme too!! I think I'd learn a lot!

+ Add a Comment