6-Optic Disc Swelling (Papilledema and Other Causes)

What is a normal CSF opening pressure in adults?

<250mm

What is a normal CSF opening pressure in children?

<280mm

What is responsible for CSF absorption?

Arachnoid villi

Papilledema is (unilateral/bilateral)

Bilateral

What VF abnormality is associated with papilledema?

Blind spot enlargement

What is the best imaging technique for identifying the presence of acute blood?

CT

What can be used as a screening tool for aneurysms?

CTA/MRA

What are the characteristic features of pseudotumor cerebri?

Elevated intracranial pressure, normal spinal fluid, and normal neuroimaging

It is estimated that ____ can contribute up to 50% to the development of pseudotumor cerebri.

Extracranial lymphatics

T/F: Normal optic nerve appearance excludes the presence of elevated ICP.

False

T/F: Papilledema due to subarachnoid or intraparenchymal hemorrhage occurs in a majority of patients

False

T/F: The absence of disc swelling rules out an intracranial mass lesion.

False

T/F: Vision loss with papilledema is stable over time.

False

What signs make you concerned that a patient with papilledema has bacterial meningitis?

Fever, Stiff Neck, Decreased mentation

What are the signs of papilledema?

Headache, NV, CN6 palsy

What is the most common mimicker of pseudotumor cerebri?

Lyme Meningitis

You see unilateral disc swelling + APD + sudden onset vision loss + impaired color vision. What is the diagnosis?

Optic Neuritis

Disc edema secondary to increased intracranial pressure

Papilledema

Term used to describe optic nerve variants or abnormalities that mimic papilledema

Pseudopapilledema

What is defined as disc elevation without without NFL edema?

Pseudopapilledema

List the common cuases of papilledema.

Tilting, Hypoplasia, crowded disc, optic disc harmatoma, optic nerve head drusen

T/F: Pseudopapilledema vision loss is stable over time.

True

T/F: When vision loss occurs with pseudotumor, it is insidious and most patients are unaware of minor deficits.

True

Optic neuritis is (unilateral/bilateral)

Unilateral

What is the greatest morbidity of pseudotumor cerebri?

Visual loss due to optic disc swelling

What is the most sensitive test for an aneurysm?

angiography