“If there are any other symptoms in addition to the dilated pupil, such as double vision, eyelid drooping or change in mental status, this is an emergency,” says Dr. Is one of your pupils bigger than the other, but you have NO other symptoms? It’s extremely unlikely that a brain tumor is the cause. If a brain tumor is causing unequal pupil size, there’s a very good chance you’ll have other symptoms such as partial facial paralysis, gait problems, weakness in a limb and speech issues, among others. Unequal pupil size is an uncommon symptom of cancer in the brain.Ī brain tumor may be primary or a metastasis from a distant primary site, such as breast cancer, pancreatic cancer or melanoma. Nevertheless, malignant brain tumors can end up infiltrating the brainstem and, among other symptoms, cause one pupil to be bigger than the other. If this brain tumor, which begins in the inner ear canal, is small and not causing symptoms, the only treatment is serial imaging to track its slow growth. Second, an acoustic neuroma is 1) very slow growing, 2) benign, and 3) often discovered by accident when the head is imaged for an unrelated reason. You would surely have seen a doctor and had this brain tumor treated well before it began pressing upon the brainstem. These symptoms are typically tinnitus (hissing, buzzing or a high frequency tone in one ear) and hearing loss in that ear. Now before you panic and think that the cause of your one dilated pupil is an acoustic neuroma, this is highly unlikely.įirst off, this rare brain tumor will cause other symptoms long before it encroaches upon the brainstem. This is when an acoustic neuroma becomes life-threatening. It may also interfere with the brainstem’s commands to make the heart beat. Howver, this slow growing brain tumor can indirectly lead to third nerve damage by pressing against the brainstem, leading to one pupil becoming dilated. One type of brain tumor that can press up against (though not invade) the brainstem is called acoustic neuroma, though the location of this growth would not directly involve the third cranial nerve - and hence, would not dilate a pupil via that route. “There are many causes of third nerve damage, but the most worrisome is compression from a brain tumor, aneurysm or swelling in the brain.” “A dilated pupil on one side could be a sign of third nerve damage,” continues Dr. Kulkarni, MD, board certified ophthalmologist and neuro-ophthalmologist in private practice in New York. “The third cranial nerve is a nerve that comes out of the brainstem (midbrain) and travels to the eye to constrict the pupil,” says Kaushal M. Not just Brain Tumor, but Aneurysm Can Make Pupils Unequal A brain tumor can cause one pupil to be bigger or more dilated than the other.īut so can less serious conditions including totally benign.
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