Quantitative pupillometry as a sensitive tool for detecting tumor-related mass effect in the posterior fossa: a prospective feasibility study comparing metastatic versus skull base lesions

Quantitative pupillometry, particularly the NPi and constriction velocities, sensitively identifies early neurological impairment from posterior fossa tumour-related mass effect. Moreover, lower preoperative NPi values were associated with postoperative neurological improvement, suggesting that pupillometry may have potential as a bedside tool to support surgical decision-making; however, these exploratory findings require validation in larger cohorts before firm predictive claims can be made."