Papilloedema

Question 1

What is papilloedema?

Answer 1

Swollen optic disc secondary to raised intracranial pressure

Question 2

If there is bilateral disc swelling, what should be suspected?

Answer 2

Raised ICP due to space occupying lesion

Question 3

Why does raised intracranial pressure impact the optic nerves so greatly?

Answer 3

The subarachnoid space surround the optic nerves is continuous with that of the brain and spinal cord

Question 4

Intracranial pressure is a sum of which 3 components?

Answer 4

1. Brain
2. Blood
3. CSF

Question 5

Which hypothesis states that the sum of the three components which contribute to intracranial pressure must remain constant and an increase in one variable must lead to a decrease in another?

Answer 5

Monro-Kellie hypothesis

Question 6

Why is it that rasied ICP is a medical emergency?

Answer 6

Brain may protrude through the foramen magnum compressing the brainstem

This may cause the patient to stop breathing and die

Question 7

What is the choroid plexus?

Answer 7

Network of capillaries which filter blood to form CSF

Question 8

In relation to CSF, which factors may lea to an increase in ICP?

Answer 8

1. Obstruction to CSF circulation
2. Overproduction
3. Inadequate absorption

Question 9

What may cause raised ICP?

Answer 9

1. Space occupying lesion
2. Malignant hypertension
3. Idiopathic intracranial hypertension
4. Issues with CSF (obstruction, overproduction, poor absorption)

Question 10

Which investigation is mandatory to determine bilateral disc swelling?

Answer 10

Ophthalmoscopy