Papilledema: Difference between revisions
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Revision as of 01:13, 24 July 2017
Background
- Bilateral optic disc swelling due to increased ICP
Etiology
- Malignant hypertension
- Idiopathic intracranial hypertension (pseudotumor cerebri)
- Intracranial mass
- Hydrocephalus
- Cerebral edema
Clinical Features
- Increased ICP symptoms:
- Headache (esp with recumbency and in the morning)
- Nausea and vomiting
- Preservation of visual acuity
- May have visual obscurations that clear completely lasting seconds
Differential Diagnosis
Evaluation
Fundoscopy
- Loss of spontaneous venous pulsations
- Disc margin blurring
- Cup is diminished or absent
Work-Up
- MRI
- CT (if MRI unavailable)
- LP (if neuroimaging normal)
- Opening pressure >25 considered abnormal
Management
- Treat underlying condition