Dilated Left Pupil That in Surgery — 27yo Man | Neurosurgery | SMLE Q#2571
SMLE Question #2571
Surgery
Neurosurgery
Objective: OBJ-310
Last updated: February 2026
A 27-year-old man is brought to the emergency department 4 hours after a high-speed motorcycle collision. He briefly lost consciousness at the scene, then was alert and talking normally. Over the past 30 minutes, he has become increasingly drowsy and confused, now responding only to painful stimuli. BP 150/88 mmHg, HR 58/min, RR 10/min. Pupils are unequal with a dilated left pupil that reacts sluggishly to light. What is the most likely diagnosis?
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