Larger 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 awake and speaking normally. Over the last 30 minutes, he has become progressively drowsy and confused and now responds only to painful stimuli. Examination shows unequal pupils with a larger left pupil that reacts sluggishly to light. What is the most likely diagnosis?
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