Papilloedema

Question 1

Define papilloedema

Answer 1

Swollen optic disc secondary to raised intracranial pressure

Question 2

Raised intracranial pressure is a medical emergency. True/False?

Answer 2

True

Question 3

What must be ruled out in patients with bilateral swollen optic discs?

Answer 3

Raised intracranial pressure due to space-occupying lesion

Question 4

What does an examination of cranial nerve II comprise of?

Answer 4

Ophthalmoscopy
Visual acuity
Visual field assessment
Pupillary response
Colour vision

Question 5

What is the pathophysiology behind true papilloedema?

Answer 5

Subarachnoid space surrounding brain is continuous with subarachnoid space surrounding optic nerve
When ICP increases, this is transmitted to the nerve, causing swollen discs

Question 6

What 3 components contribute to intracranial pressure?

Answer 6

Brain
CSF
Blood

Question 7

How does a patient die from raised ICP as a result of increased brain size?

Answer 7

Brain squeezes through foramen magnum and compresses brainstem, inhibiting respiratory centre - patient can’t breathe and dies

Question 8

The brain is very tolerant of hypo/hyper -perfusion. True/False?

Answer 8

False

Needs constant blood supply over range of pressures

Question 9

What factors relating to CSF contribute to raised ICP?

Answer 9

Obstruction to CSF circulation
Overproduction of CSF
Inadequate absorption of CSF

Question 10

If a CT is normal following suspected raised ICP, what is done?

Answer 10

Lumbar puncture to assess CSF