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papilledema

Papilledema

Or papilloedema is optic disc swelling that is caused by intracranial hypertension. The swelling is usually bilateral and can occur over a period of hours to weeks. Unilateral presentation is extremely rare. Papilledema is mostly seen as a symptom resulting from another pathophysiological process.

In intracranial hypertension, papilledema most commonly occurs bilaterally. When papilledema is found on funduscopy, further evaluation is warranted as vision loss can result if the underlying condition is not treated. Further evaluation with a CT or MRI of the brain and/or spine is usually performed.

see Foster Kennedy syndrome contralateral papilledema (from elevated ICP)

Etiology

Unilateral papilledema can suggest orbital pathology, such as an optic nerve glioma.

Idiopathic intracranial hypertension.

The decision to admit a shunt-treated patient from the emergency department for symptoms related to idiopathic intracranial hypertension (IIH) is challenging. Knowledge of factors associated with the need for admission and/or shunt revision is required. In a study, factors such as male sex, younger age at presentation, lower number of prior emergency department visits, and performance of a diagnostic LP were independent predictors of admission. In addition, papilledema was strongly predictive of the need for shunt revision, highlighting the importance of an ophthalmological examination for shunt-treated adults with IIH who present to the emergency department 1).

1)
Sankey EW, Elder BD, Liu A, Carson KA, Goodwin CR, Jusué-Torres I, Rigamonti D. Predictors of admission and shunt revision during emergency department visits for shunt-treated adult patients with idiopathic intracranial hypertension. J Neurosurg. 2017 Aug;127(2):233-239. doi: 10.3171/2016.5.JNS151303. Epub 2016 Sep 23. PubMed PMID: 27662535.
papilledema.txt · Last modified: 2019/04/27 20:22 by administrador