Papilloedema

Question 1

How do the terms “swollen optic disc” and “papilloedema” differ in meaning?

Answer 1

Swollen optic discs- disc swelling secondary to any cause

Papilloedema- specific term meaning swollen optic disc secondary to raised ICP

Question 2

What should all patients with bilateral optic disc swelling be suspected of having, until proven otherwise?

Answer 2

Raised ICP due to a SOL

Question 3

What does the optic nerve exam involve?

Answer 3

Opthalmoscopy
Visual acuity
Pupil exam
Visual field assessment

Question 4

How does raised ICP in the subarachnoid space surrounding the brain cause swollen optic discs?

Answer 4

Transmitted along the SA space in the optic nerve sheath causing interruption of axoplasmic flow and venous congestion

Question 5

How does raised ICP ultimately lead to death?

Answer 5

Compression of the brainstem in the foramen magnum leading to cessation of breathing

Question 6

What should always be checked in the case of disc swelling?

Answer 6

Blood pressure (malignant hypertension can cause swollen disc/papilloedema)

Question 7

What is the choroid plexus?

Answer 7

Network of capillaries filtering blood to form CSF

Question 8

Which three scenarios relating to CSF flow can cause raised ICP?

Answer 8

Obstruction to flow
Inadequate reabsorption
Overproduction

Question 9

What are the symptoms of idiopathic intercranial hypertension? Which group of patients gets IIH?

Answer 9

Headache, visual loss due to optic nerve atrophy.
Obese women of childbearing age
(rare disease)

Question 10

What are the roles of the CSF?

Answer 10

Bouyancy/protection
Nutrition
Waste removal
Maintenance of stable external environment for the brain