Optic Disc Edema and Elevated Intracranial Pressure (ICP): A Comprehensive Review of Papilledema

Reier, Louis; Fowler, James B.; Arshad, Mohammad Yusof; Hadi, Hamid A.; Whitney, Eric; Farmah, Anthony V; Siddiqi, Javed

doi:10.7759/cureus.24915

Cited by 9 publications

(11 citation statements)

References 74 publications

(91 reference statements)

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“…The precise mechanisms of optic nerve involvement in IIH are not completely understood but it is possible that raised intracranial pressure results in ischemic and compressive effects on the optic nerve. [12][13][14] Another possibility is that structural abnormalities, such as degenerative changes, take place in the optic nerve due to raised intracranial pressure. Optic nerve sheath diameter and sonoelastography optic nerve studies reinforce this possibility.…”

Section: Discussionmentioning

confidence: 99%

Higher cerebrospinal fluid (CSF) opening pressure in patients with idiopatic intracranial hypertension (IIH) with permanent visual impairment

Domingues

Senne²,

Lacerda

2022

Headache Med

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Objective The aim of this study was to identify potential visual prognostic markers in patients with idiopathic intracranial hypertension (IIH). Methods Patients with IIH of an outpatient headache clinic in São Paulo, Brazil, were retrospectively evaluated and divided in two groups with and without the presence of permanent visual deficit attributed to IIH. Body mass index (BMI), opening CSF pressure, and the frequency of IIH related MRI abnormalities were compared between these two groups. Results Twenty-nine patients, with 35,39±9,93 years, being twenty-eight female (96.55%) were included in the study. Reduced visual acuity attributed to IIH was registered in 16 (55.17%). According to BMI 17.4% had overweight and 82.6% were obese. Brain MRI was normal in 6 (20.69%). BMI, obesity, and the presence of MRI abnormalities were not associated with visual impairment. Initial CSF opening pressure was significantly higher in the group of patients with reduced visual acuity (40.4±13.14 x 30.5±3.41, P=0,015). Conclusion Higher CSF opening pressure at onset was significantly associated with a higher percentage of visual impairment in patients with IIH suggesting this measure as a potential prognostic marker for patients with IIH.

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Section: Discussionmentioning

confidence: 99%

Higher cerebrospinal fluid (CSF) opening pressure in patients with idiopatic intracranial hypertension (IIH) with permanent visual impairment

Domingues

Senne²,

Lacerda

2022

Headache Med

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“…Finally, although not the primary learning point from this case report, another interesting finding seen was the partial empty sella sign on postoperative MRI (as seen in Figure 5 ). In the literature, the empty sella sign is either attributed to elevated intracranial pressure (ICP) or reported as an incidental finding [ 21 ]. Interestingly, our patient developed this finding prior to ventricle size change or the onset of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Metastatic Urothelial Cell Carcinoma Presenting as an Isolated Malignancy to the Posterior Fossa: A Case Report and Review on the Literature

Reier¹,

Pudewa²,

Hough³

et al. 2022

Cureus

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Urothelial cell carcinoma (UCC) of the bladder infrequently metastasizes to the central nervous system (CNS). The incidence worldwide is approximately 1%. The cerebral hemispheres of the anterior and middle cranial fossa are the most common sites of CNS spread, and usually, multiple metastatic lesions are present. Infrequently, metastasis presents as a single solitary metastatic malignancy to the posterior fossa. Here, we present the case of a patient with bladder UCC who presented with a single solitary metastatic malignancy to the cerebellum. The authors discuss the signs, symptoms, mechanism of metastatic spread to the CNS, diagnosis, management, and prognosis of isolated posterior fossa metastasis originating from bladder UCC. We also performed an extensive literature search to identify all cases of metastatic bladder UCC presenting as an isolated malignancy to the posterior fossa in the past 20 years.

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“…Картина глазного дна при различных причинах изменений ДЗН может быть схожей. А изолированное использование доступных методов офтальмологического обследования часто не дает необходимой для диагностики информации [2][3][4].…”

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“…При этом комплексное применение неинвазивных методик оценки ЗДЗН может стать важным источником информации для раннего выявления и оценки динамики ВЧД, а также формирования прогноза для зрительной функции пациента. Развитие отека ДЗН при тромбозе венозных синусов мозга или внутренней яремной вены происходит в результате нарушения оттока венозной крови от тканей мозга, что служит причиной повышения ВЧД [1,4].…”

unclassified

“…Повышение ВЧД и отек ДЗН на фоне черепно-мозговой травмы происходит из-за внутричерепного кровоизлияния, тромбоза венозного синуса или отека мозга. Реже повреждение спинного мозга приводит к повышению ВЧД из-за высокой концентрации белка в ЦСЖ, что способствует ухудшению ее абсорбции [1,4].…”

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Papilledema: A Problem of Modern Ophthalmology, Neurology, and Neurosurgery

Крамаренко¹,

Марьенко²

2023

Неврология И Нейрохирургия. Восточная Европа

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Застойный диск зрительного нерва (ЗДЗН) – отек диска зрительного нерва, вызванный повышенным внутричерепным давлением и обычно носящий билатеральный характер. В работе представлен обзор актуальных данных по патогенезу, эпидемиологии, классификации, дифференциальной диагностике, особенностям протекания ЗДЗН и прогнозам для зрения в исходе заболевания. Дифференциальная диагностика ЗДЗН и других изменений диска зрительного нерва (ДЗН), схожих по офтальмоскопической картине, по-прежнему представляет серьезную трудность. Имеющиеся методы диагностики при их изолированном использовании не всегда могут помочь дифференцировать отек и псевдоотек ДЗН. Решение этой задачи часто требует мультимодального офтальмологического обследования и междисциплинарного подхода. Наблюдается существенный недостаток данных о специфичных признаках, характерных для истинного ЗДЗН. Изучение корреляции состояния зрительного нерва с уровнем внутричерепного давления может помочь в разработке критериев неинвазивной диагностики повышенного внутричерепного давления. Papilledema is optic disk swelling, caused by increased intracranial pressure and usually having a bilateral pattern. We present a review of current data on pathogenesis, epidemiology, classification, differential diagnosis, edema evolution and visual outcome prognosis. Differential diagnosis of the papilledema and other similar optic disc changes is still difficult. The available diagnostic methods, when used isolated, not always can help in differentiating between papilledema and pseudopapilledema. The solution often requires a multimodal ophthalmological examination and an interdisciplinary approach. There is a significant lack of data on the specific diagnostic features for true papilledema. Thorough studying of the correlation between the optic nerve status and the intracranial pressure level may help in elaborating criteria for non-invasive diagnosis of increased intracranial pressure.

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Optic Disc Edema and Elevated Intracranial Pressure (ICP): A Comprehensive Review of Papilledema

Cited by 9 publications

References 74 publications

Higher cerebrospinal fluid (CSF) opening pressure in patients with idiopatic intracranial hypertension (IIH) with permanent visual impairment

Higher cerebrospinal fluid (CSF) opening pressure in patients with idiopatic intracranial hypertension (IIH) with permanent visual impairment

Metastatic Urothelial Cell Carcinoma Presenting as an Isolated Malignancy to the Posterior Fossa: A Case Report and Review on the Literature

Papilledema: A Problem of Modern Ophthalmology, Neurology, and Neurosurgery

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