Papilloedema

Question 1

what is meant by papilloedema?

Answer 1

specific term meaning swollen optic discs secondary to raised intra-cranial pressure

Question 2

how is a ‘swollen optic disc’ different from papilloedema?

Answer 2

a swollen optic disc can be secondary to ANY cause

Question 3

what does the assesment of CN II involve?

Answer 3

• ophthalmoscopy
• visual acuity
• pupil exam
• visual field assessment
• colour vision

Question 4

how is increased ICP transmitted to the optic discs?

Answer 4

when ICP is raised this is transmitted to the subarachnoid space surrounding the brain which is continous with the subarachnoid space around the optic nerve

Question 5

what are the 3 components that can contribute to ICP?

Answer 5

1. brain
2. blood
3. CSF

Question 6

what is the monro-kellie hypothesis?

Answer 6

the sum of ICP must remain constant ie an increase in one variable will result in a decrease of one/both other variables

Question 7

how can raised ICP be fatal?

Answer 7

with raised ICP, brain is squeezed through foramen magnum, brainstem is compressed, patient stops breathing and dies

Question 8

what should you always check when someone has disc swelling? and why?

Answer 8

blood pressure, could be malignant hypertension

Question 9

What mechanism can cause raised ICP with CSF?

Answer 9

• obstruction of CSF circulation
• overproduction of CSF
• inadequate absorption

Question 10

what are the 2 main investigations for raised ICP?

Answer 10

head CT and lumbar puncture

Question 11

if disc swelling is chronic, what happens when the swelling subsides?

Answer 11

discs become atrophic and pale