Papilloedema Flashcards
(15 cards)
What is papilloedema?
Swelling of the optic disc due to raised intracranial pressure (ICP)
What cranial nerve is involved in papilloedema?
Optic nerve (CN II)
What is the Monro-Kellie hypothesis?
The skull is a fixed volume made of brain, CSF, and blood.
An increase in one must be compensated by a decrease in another to maintain normal ICP
Name three causes of raised ICP
- Space-occupying lesion
(e.g. tumour/bleed) - Problems with cerebral blood flow (e.g. malignant hypertension)
- CSF problems (e.g. hydrocephalus)
What is a common cause of bilateral disc swelling in young females?
Idiopathic intracranial hypertension
What are the visual symptoms of papilloedema?
(1) Enlarged blind spot
(2) Visual blurring
(3) Transient obscurations
(4) Eventual vision loss
What other symptoms may occur in raised ICP?
Headache, nausea, vomiting
What would fundoscopy show in papilloedema?
Blurred optic disc margins and disc swelling
What is the management of papilloedema?
Treat the underlying cause of raised ICP
What is a major complication of chronic papilloedema?
Optic atrophy → permanent vision loss or blindness
You only give antibiotics before lumbar puncture (LP) when what?
(1) if there’s a risk of raised ICP
(2) if the child is very sick
(eg, septic, GCS ↓, shock)
‘Young woman, high BMI, headache and visual symptoms’
This suggests what?
Idiopathic intracranial hypertension
A 25-year-old female patient presents to her GP due to a severe throbbing headache, which is worst first thing in the morning. This has happened for several weeks, with no response for paracetamol. She has also been vomiting on most mornings and feels that her vision has been blurry.
Her pupils are equal and reactive, and systemic examination is normal.
What would you expect to see on fundoscopy?
Blurring of optic disc margin
A 54-year-old man is noted to have papilledema on examination.
What biochemical abnormality may be responsible?
Hypercapnia
= Too much carbon dioxide (CO₂) in the blood. It usually happens when someone can’t breathe properly, so CO₂ builds up
Papilloedema indicates raised intracranial pressure and thus would contraindicate what?
Lumbar puncture = do CT of head instead
