Papilledema

Background

1. Bilateral optic disc swelling due to increased ICP
2. Etiology
   1. Malignant hypertension
   2. Idiopathic intracranial hypertension (pseudotumor cerebri)
   3. Intracranial mass
   4. Hydrocephalus
   5. Cerebral edema

Clinical Features

1. Increased ICP symptoms:
   1. Headache (esp w/ recumbency and in the morning)
   2. N/V
2. Preservation of visual acuity
   1. May have visual obscurations that clear completely lasting seconds

Diagnosis

1. Fundoscopy
   1. Loss of spontaneous venous pulsations
   2. Disc margin blurring
   3. Cup is diminished or absent

Work-Up

1. MRI
2. CT (if MRI unavailable)
3. LP (if neuroimaging normal)
   1. Opening pressure >25 considered abnormal

Treatment

1. Treat underlying condition