Final answer:
Dilated pupils can indicate brainstem involvement during the surgical procedure.
Step-by-step explanation:
Brainstem involvement during the surgical procedure can cause several signs, including dilated pupils. The brainstem is responsible for controlling the pupils' constriction and dilation, so any disruption can lead to dilated pupils. Increased heart rate (option a) may be a sign of stress or discomfort, but it is not specific to brainstem involvement. Improved motor function (option c) and increased urine output (option d) are not directly influenced by brainstem involvement.