Papilloedema

Question 1

What is papilloedema?

Answer 1

swollen optic discs secondary to raised intracranial pressure (ICP)

Question 2

All patients with bilateral optic disc swelling should be suspected of having raised ICP due to a space occupying lesion (SOL) until proven otherwise. TRUE/FALSE?

Answer 2

TRUE

Question 3

What are the main parts of a cranial nerve II exam?

Answer 3

visual acuity
pupil exam
visual field assessment
colour vision

Question 4

Raised intracranial pressure in the sub arachnoid space has what effect on the eyes?

Answer 4

Causes interruption of axoplasmic flow and venous congestion
=> swollen discs

Question 5

What are the 3 components which can affect the intracranial pressure?

Answer 5

Brain 80%
Blood 10%
CSF 10%

an increase in one variable causes decrease in the other

Question 6

A normal intracranial pressure can be maintained when a mass expands initially in the skull. TRUE/FALSE?

Answer 6

TRUE

eventually small increments in volume cause large rises in ICP

Question 7

Blood pressure should always be checked when there is a swollen disc. TRUE/FALSE?

Answer 7

TRUE

think malignant hypertension

Question 8

What are the main functions of the CSF?

Answer 8

• Maintains stable extracellular environment for the brain
• Buoyancy
• Provides mechanical protection
• Waste removal
• Nutrition

Question 9

Describe what is meant by Idiopathic Intracranial Hypertension?

Answer 9

Cause of raised ICP unknown

Question 10

How can raised intra-abdominal pressure cause raised ICP?

Answer 10

Increased abdominal pressure
impaired venous return
raised intra-cranial pressure

Question 11

Give an example of a condition which is thought to impair CSF absorption

Answer 11

microemboli in sagittal sinus

Question 12

What can happen if disc swelling becomes chronic

Answer 12

• Disc swelling subsides
• Discs become atrophic and pale
• Loss of visual function occurs
• Potential blindness