Papilloedema

Question 1

What should all patients with bilateral optic disc swelling be suspected of having?

Answer 1

raised ICP due to a space occupying lesion (SOL) until proven otherwise

Question 2

Describe the pathophysiology of papilloedema.

Answer 2

Subarachnoid space (SAS) around optic nerve (ON) continuous with subarachnoid space surrounding the brain

When intracranial pressure increases, this is transmitted to the SAS then to the ON…..

This causes interruption of axoplasmic flow and venous congestion= swollen discs

Question 3

Which 3 components are involved in intra cranial pressure?

Answer 3

1 Brain (80%)
2 Blood (10%)
3 CSF (10%)

Question 4

Does the cranial vault expand with increasing ICP ?

Answer 4

no - it is rigid

Question 5

Do all patients with raised ICP have a space occupying lesion?

Answer 5

no

Question 6

What are the functions of CSF?

Answer 6

Maintains stable extracellular environment for the brain
Buoyancy
Provides mechanical protection
Waste removal
Nutrition

Question 7

Where is CSF produced and where does it go?

Answer 7

Most produced in lateral ventricles by choroid plexus

CSF travels through 3rd and 4th ventricles into subarachnoid space

Question 8

What is the choroid plexus?

Answer 8

network of capillaries which filter blood to form CSF

Question 9

What 3 things can lead to raised ICP?

Answer 9

Obstruction to CSF circulation
Overproduction of CSF
Inadequate absorption

Question 10

What happens if disc swelling becomes constant?

Answer 10

Disc swelling subsides, discs become atrophic and pale.

Loss of visual function occurs and blindness may result

Question 11

Ophthalmoscopy is part which cranial nerve examination?

Answer 11

cranial nerve II examination