Unusual causes of papilledema: Two illustrative cases

Abstract

Background:Neurosurgeons are frequently among the first physicians asked to evaluate patients with papilledema, and the patient is often referred with the implication that they may require shunting. After an initial evaluation to exclude potential neurosurgical emergencies, the physician should carefully consider various etiologies of papilledema to prevent unnecessary neurosurgical operations.Case Description:The authors report two illustrative cases of unusual causes of papilledema: Anemia and leukemic infiltration of the central nervous system. In each case, a complete blood count provided clues for the diagnosis. A review of the literature is also included.Conclusions:Both patients responded to medical management/treatment of the underlying disease and did not require neurosurgical operative intervention. Papilledema may be caused by other etiologies besides increased intracranial pressure. The authors present two unusual cases leading to papilledema and provide an outline for the workup of these conditions.

Acute Myeloid Leukemia Masquerading as Idiopathic Intracranial Hypertension: A Rare Initial Presentation

“…One hypothesis to understand IIH is that increased viscosity resulting from lymphocytosis can lead to reduced CSF absorption. 11 , 12 This could be a likely cause in our patient as he had an elevated systemic WBC count. It also has been speculated that blasts cells can infiltrate the arachnoid granulations directly and alter CSF absorption.…”