Papilledema: Difference between revisions

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(/* Causes in Alphabetical Order Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016 Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massa...)
(/* Causes in Alphabetical Order Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016 Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massa...)
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==Causes in Alphabetical Order <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>==
*===Causes in Alphabetical Order ===


{{MultiCol}}
* {{MultiCol}}


[[Acid Base Imbalance]]
* [[Acid Base Imbalance]]


[[Acute liver failure]]
* [[Acute liver failure]]


[[Acute lymphocytic leukemia]]
* [[Acute lymphocytic leukemia]]


[[Adult low grade infiltrative suoratentorial astrocytoma]]
* [[Adult low grade infiltrative suoratentorial astrocytoma]]


[[Age related macular degeneration]]
* [[Age related macular degeneration]]


[[Amaurosis fugax]]
* [[Amaurosis fugax]]


[[Anterior ischemic optic neuropathy]]
* [[Anterior ischemic optic neuropathy]]


[[Arachnoid cyst]]
* [[Arachnoid cyst]]


[[Arnold chiari malformation]]
* [[Arnold chiari malformation]]


[[Arsenicals]]
* [[Arsenicals]]


[[Brain Abscess]]
* [[Brain Abscess]]


[[Brain cyst]]
* [[Brain cyst]]


[[Brain Stem Gliomas]]
* [[Brain Stem Gliomas]]


[[Brain tumor]]
* [[Brain tumor]]


[[Brown - symmers disease]]
* [[Brown - symmers disease]]


[[Brucellosis]]
* [[Brucellosis]]


[[Camurati-Engelmann disease]]
* [[Camurati-Engelmann disease]]


[[Carbon monoxide toxity]]
* [[Carbon monoxide toxity]]


[[Cavernous Sinus Thrombosis]]
* [[Cavernous Sinus Thrombosis]]


[[Central retinal vein occlusion]]
* [[Central retinal vein occlusion]]


[[Cerebellar abscess]]
* [[Cerebellar abscess]]


[[Cerebral abscess]]
* [[Cerebral abscess]]


[[Cerebral edema]]
* [[Cerebral edema]]


[[Cerebral venous sinus thrombosis]]
* [[Cerebral venous sinus thrombosis]]


[[Chondroma]]
* [[Chondroma]]


[[Chorioretinitis]]
* [[Chorioretinitis]]


[[Choroid plexus neoplasm]]
* [[Choroid plexus neoplasm]]


[[Cisplatin]]
* [[Cisplatin]]


[[Corticosteroid]]
* [[Corticosteroid]]


[[Crouzon syndrome]]
* [[Crouzon syndrome]]


[[Cushing's disease]]
* [[Cushing's disease]]


[[Dandy-Walker syndrome]]
* [[Dandy-Walker syndrome]]


[[Deafness- peripheral- neuropathy- arterial disease]]
* [[Deafness- peripheral- neuropathy- arterial disease]]


[[Diabetic retinopathy]]
* [[Diabetic retinopathy]]


[[Eclampsia]]
* [[Eclampsia]]


[[Epidural abscess]]
* [[Epidural abscess]]


[[Epidural hematoma]]
* [[Epidural hematoma]]


[[Ethylene glycol]]
* [[Ethylene glycol]]


[[Fabry's Disease]]
* [[Fabry's Disease]]


[[Foster Kennedy syndrome]]
* [[Foster Kennedy syndrome]]


[[Glaucoma]]
* [[Glaucoma]]


[[Growth hormone treatment]]
* [[Growth hormone treatment]]


[[Gullian-Barre syndrome]]
* [[Gullian-Barre syndrome]]


[[Head trauma]]
* [[Head trauma]]


[[Hydrocephalus]]
* [[Hydrocephalus]]


[[Hypercapnia]]
* [[Hypercapnia]]


[[Hypertension]]
* [[Hypertension]]


{{ColBreak}}
* {{ColBreak}}


[[Hypertensive encephalopathy]]
* [[Hypertensive encephalopathy]]


[[Hypertensive retinopathy]]
* [[Hypertensive retinopathy]]


[[Hypocalcemic tetany]]
* [[Hypocalcemic tetany]]


[[Idiopathic intracranial hypertension]]
* [[Idiopathic intracranial hypertension]]


[[Infective endocarditis]]
* [[Infective endocarditis]]


[[Insulin like growth factor 1]]
* [[Insulin like growth factor 1]]


[[Interleukin 11]]
* [[Interleukin 11]]


[[Intracranial bleeding]]
* [[Intracranial bleeding]]


[[Isotretinoin]]
* [[Isotretinoin]]


[[Lithium]]
* [[Lithium]]


[[Malignant Astrocytomas]]
* [[Malignant Astrocytomas]]


[[Medulloblastoma]]
* [[Medulloblastoma]]


[[Meningitis]]
* [[Meningitis]]


[[Meningoencephalitis]]
* [[Meningoencephalitis]]


[[Methanol]]
* [[Methanol]]


[[Minocycline]]
* [[Minocycline]]


[[Myoclonic epilepsy]]
* [[Myoclonic epilepsy]]


[[Neuroectodermal tumor primitive]]
* [[Neuroectodermal tumor primitive]]


[[Neuropapillitis]]
* [[Neuropapillitis]]


[[Nutritional optic neuropathy]]
* [[Nutritional optic neuropathy]]


[[Obesity hypoventilation syndrome]]
* [[Obesity hypoventilation syndrome]]


[[Optic disc drusen]]
* [[Optic disc drusen]]


[[Optic disc vasculitis]]
* [[Optic disc vasculitis]]


[[Optic neuritis]]
* [[Optic neuritis]]


[[Optic neuropathy]]
* [[Optic neuropathy]]


[[Orbital lesion]]
* [[Orbital lesion]]


[[Orbital optic nerve tumors]]
* [[Orbital optic nerve tumors]]


[[Osteoma]]
* [[Osteoma]]


[[Paget's disease]]
* [[Paget's disease]]


[[Papillitis]]
* [[Papillitis]]


[[Paragonimiasis]]
* [[Paragonimiasis]]


[[Parinaud's syndrome]]
* [[Parinaud's syndrome]]


[[POEMS syndrome]]
* [[POEMS syndrome]]


[[Respiratory acidosis]]
* [[Respiratory acidosis]]


[[Sarcoidosis]]
* [[Sarcoidosis]]


[[Scleritis]]
* [[Scleritis]]


[[Subarachnoid hemmorhage]]
* [[Subarachnoid hemmorhage]]


[[Subdural empyema]]
* [[Subdural empyema]]


[[Subdural hematoma]]
* [[Subdural hematoma]]


[[Sympathetic ophthalmia]]
* [[Sympathetic ophthalmia]]


[[Syphillis]]
* [[Syphillis]]


[[ Systemic Lupus Erythematosus]]
* [[ Systemic Lupus Erythematosus]]


[[Tetracycline]]
* [[Tetracycline]]


[[Thyroid opthalmopathy]]
* [[Thyroid opthalmopathy]]


[[Toxic optic neuropathy]]
* [[Toxic optic neuropathy]]


[[Toxoplasmosis]]
* [[Toxoplasmosis]]


[[Tuberous sclerosis]]
* [[Tuberous sclerosis]]


[[Tumor lysis syndrome]]
* [[Tumor lysis syndrome]]


[[Vogt-Koyanagi-Harada syndrome]]
* [[Vogt-Koyanagi-Harada syndrome]]


* {{EndMultiCOL}}
* {{EndMultiColl}}


==Differentiation of Papilledema from other Disorders==
==Differentiation of Papilledema from other Disorders==

Revision as of 02:47, 16 July 2012

Papilledema
Papilledema.
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology
ICD-10 H47.1
ICD-9 377.0
DiseasesDB 9580
MeSH D010211

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Kalsang Dolma, M.D.

Synonyms and Keywords: papilloedema

Overview

Papilledema is defined as swelling of the optic disc that is caused by increased intracranial pressure. The swelling is usually bilateral and can occur over a period of hours to weeks.

Pathophysiology

As the optic nerve sheath is continuous with the subarachnoid space of the brain (and is regarded as an extension of the central nervous system), increased pressure is transmitted through to the optic nerve. The brain itself is relatively spared from pathological consequences of high pressure.

However, the anterior end of the optic nerve stops abruptly at the eye. Hence the pressure is asymmetrical and this causes a pinching and protrusion of the optic nerve at its head.

The fibers of the retinal ganglion cells of the optic disc become engorged and bulge anteriorly. Persistent and extensive optic nerve head swelling, or optic disc edema, can lead to loss of these fibers and permanent visual impairment.

Causes

Common Causes

Hydrocephalus

Cerebral edema

Intracranial bleeding

Brain tumor

Cerebral venous sinus thrombosis

Idiopathic intracranial hypertension

Optic neuritis

Optic neuropathy

Choroid plexus neoplasm

Hypertension

Causes by Organ System

Cardiovascular Hypertension, Hypertensive encephalopathy, Hypertensive retinopathy
Chemical / poisoning Methanol, Ethylene glycol
Dermatologic No underlying causes
Drug Side Effect Cisplatin, Corticosteroid, Growth hormone treatment, Insulin-like growth factor 1, Interleukin 11, Isotretinoin, Lithium, Minocycline, Tetracycline
Ear Nose Throat No underlying causes
Endocrine Cushing's disease, Diabetic retinopathy, Thyroid opthalmopathy
Environmental No underlying causes
Gastroenterologic Acute liver failure
Genetic Camurati - Engelmann disease, Crouzon syndrome, Fabry's Disease, Tuberous sclerosis, Vogt-Koyanagi-Harada syndrome
Hematologic Acute lymphocytic leukemia
Iatrogenic No underlying causes
Infectious Disease Brucellosis, Epidural abscess, Infective endocarditis, Meningitis, Meningoencephalitis, Paragonimiasis, Syphillis, Toxoplasmosis
Musculoskeletal / Ortho Paget's disease
Neurologic Cavernous Sinus Thrombosis, Arachnoid cyst, Arnold chiari malformation, Brain Abscess, Brain cyst, Brown - symmers disease, Cerebellar abscess,

Cerebral abscess, Cerebral venous sinus thrombosis, Dandy-Walker syndrome, Epidural hematoma, Foster kennedy syndrome, Intracranial bleeding Medulloblastoma, Myoclonic epilepsy, Parinaud's syndrome, Subarachnoid hemmorhage, Subdural empyema, Subdural hematoma, Hydrocephalus, Cerebral edema, Gullian-Barre syndrome

Nutritional / Metabolic Nutritional optic neuropathy
Obstetric/Gynecologic Eclampsia
Oncologic Adult low grade infiltrative suoratentorial astrocytoma, Brain Stem Gliomas, Brain tumor, Chondroma, Choroid plexus neoplasm, Malignant Astrocytomas, Neuroectodermal tumor primitive, Osteoma, Tumor lysis syndrome, Acute lymphocytic leukemia
Opthalmologic Amaurosis fugax, Chorioretinitis, Glaucoma, Neuropapillitis, Optic disc drusen, Optic disc vasculitis, Optic neuritis, Orbital lesion, Orbital optic nerve tumors, Papillitis, Scleritis, Age related macular degeneration, Anterior ischemic optic neuropathy, Central retinal vein occlusion, Optic neuropathy
Overdose / Toxicity Arsenicals, Carbon monoxide toxity, Ethylene glycol
Psychiatric No underlying causes
Pulmonary Hypercapnia, Obesity hypoventilation syndrome, Respiratory acidosis
Renal / Electrolyte Acid Base Imbalance, Hypocalcemic tetany
Rheum / Immune / Allergy Sarcoidosis, Sympathetic ophthalmia, Systemic Lupus Erythematosus
Sexual No underlying causes
Trauma Head trauma
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Idiopathic intracranial hypertension, POEMS syndrome, Deafness- peripheral- neuropathy- arterial disease
  • ===Causes in Alphabetical Order ===

Differentiation of Papilledema from other Disorders

Papilledema should be distinguished from pseudopapilledema which is caused by

Epidemiology and Demographics

Papilledema occurs in approximately 50% of those with a brain tumour.

Diagnosis

Checking the eyes for signs of papilledema should be carried out whenever there is a clinical suspicion of raised intracranial pressure. Because of the (rare) possibility of a brain tumor, pseudotumor cerebri or cerebral venous sinus thrombosis, all of which can increase intracranial pressure, this examination has become common for patients suffering from headaches.

Physical Examination

Eyes

Images shown below are courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

  • Papilledema.

    Papilledema.

  • Pseudopapilledema.

    Pseudopapilledema.

There are 10 hallmarks of papilledema:

References

de:Stauungspapille it:Papilledema


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