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__NOTOC__
{{Infobox_Disease |
{{Infobox_Disease |
   Name          = Papilledema  |
   Name          = Papilledema  |
   Image          = Papilledema 1.jpg|
   Image          = Papilledema 1.jpg|
   Caption        = Papilledema. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|
   Caption        = Papilledema. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|
  DiseasesDB    = 9580 |
  ICD10          = {{ICD10|H|47|1|h|46}} |
  ICD9          = {{ICD9|377.0}}  |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  eMedicineSubj  = oph |
  eMedicineTopic = 187 |
  MeshID        = D010211 |
}}
}}
{{Search infobox}}
{{Papilledema}}
{{CMG}}
'''For patient information, click [[Papilledema (patient information)|here]]'''


{{editor help}}
{{CMG}}; {{AE}} {{KD}}


== Overview ==
'''''Synonyms and Keywords:''''' Papilloedema
'''Papilledema''' (or '''papilloedema''') is [[optic disc]] swelling that is caused by increased [[intracranial pressure]]. The swelling is usually bilateral and can occur over a period of hours to weeks. Papilledema occurs in approximately 50% of those with a [[brain tumour]].


==Pathophysiology==
==[[Papilledema overview|Overview]]==
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. 
==[[Papilledema historical perspective|Historical Perspective]]==


The fibers of the [[Ganglion cell|retinal ganglion cell]]s 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.
==[[Papilledema classification|Classification]]==


==Differential diagnosis of causes of papilledema==
==[[Papilledema pathophysiology|Pathophysiology]]==


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>
==[[Papilledema causes|Causes]]==


*[[Arachnoid cyst]]
==[[Papilledema differential diagnosis|Differentiating Papilledema from other Diseases]]==
*[[Arnold chiari malformation]]
*Atypical [[optic neuritis]]
*[[Brain cyst]]
*[[Brain tumor]]
*[[Cavernous sinus thrombosis]]
*[[Central retinal vein occlusion]]
*[[Cerebral abscess]]
*[[Chondroma]]
*[[Cisplatin]]
*[[Corticosteroids]]
*[[Crouzon's disease]]
*[[Cushing's syndrome]]
*[[Diabetic]] papillopathy
*[[Eclampsia]]
*[[Epidural hematoma]]
*Extradural [[abscess]]
*Foster Kennedy's syndrome
*[[Grave's opthalmopathy]]
*[[Head trauma]]
*[[Hypercapnia]]
*[[Hyperparathyroidism]]
*Hypertensive [[encephalopathy]]
*[[Hypocalcemic tetany]]
*Idiopathic [[intracranial hypertension]]
*[[Intracranial hemorrhage]]
*Infectious [[endocarditis]]
*[[Lithium]]
*[[Hydrocephalus]]
*[[Malignant hypertension]]
*[[Meningitis]]
*[[Meningoencephalitis]]
*Neuropappilitis
*[[Optic disc]] [[vasculitis]]
*Orbital lesions
*Orbital [[optic nerve]] tumors
*[[Osteoma]]
*[[Paget's disease]]
*Papillitis
*Psuedopapilledema
*[[Sarcoidosis]]
*[[Subarachnoid hemorrhage]]
*[[Subdural empyema]]
*[[Subdural hematoma]]
*[[Syphillis]]
*[[Systemic lupus erythematosus]]
*[[Tetracyclines]]
*[[Thyrotoxicosis]]
*[[Uveitis]]


==Diagnosis==
==[[Papilledema epidemiology and demographics|Epidemiology and Demographics]]==


Checking the [[eye]]s for [[sign (medicine)|sign]]s 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 [[headache]]s.
==[[Papilledema Natural History, Complications and Prognosis|Natural History, Complications and Prognosis]]==


=== Physical Examination ===
==Diagnosis==
[[Papilledema history and symptoms|History and Symptoms]] | [[Papilledema physical examination|Physical Examination]] |  [[Papilledema CT|CT]] | [[Papilledema MRI|MRI]] | [[Papilledema other imaging findings|Other Imaging Findings]] | [[Papilledema  other diagnostic studies|Other Diagnostic Studies]]


==== Eyes ====
==Treatment==
[[Papilledema medical therapy|Medical Therapy]] | [[Papilledema surgery|Surgery]] | [[Papilledema primary prevention|Primary Prevention]]  | [[Papilledema cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Papilledema future or investigational therapies|Future or Investigational Therapies]]


[http://www.peir.net Images shown below are courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]  
== Case Studies ==
[[Papilledema case study one|Case #1]]


<div align="left">
==Related Chapters==
<gallery heights="175" widths="175">
* [[Cerebral edema]]
Image:Papilledema 1.jpg|Papilledema.
* [[Intracranial pressure]]
Image:Pseudopapilledema.jpg|Pseudopapilledema.
* [[Raised intracranial pressure]]
</gallery>
 
==Presentation==
There are 10 hallmarks of '''papilledema''':
*blurring of the [[disc margins]]
*filling in of the [[optic disc cup]]
*anterior bulging of the [[nerve head]]
*edema of the nerve fiber layer
*retinal or [[choroidal]] folds
*congestion of [[retinal veins]]
*peripapillary [[hemorrhages]]
*hyperemia of the optic nerve head
*nerve fiber layer infarcts
*hard exudates of the [[optic disc]]
 
==External links==
* {{MerckManual|8|101|a}}
* {{FPnotebook|EYE38}}
* [http://health.enotes.com/medicine-encyclopedia/papilledema eNotes]


{{Eye pathology}}
{{Eye pathology}}
{{SIB}}
[[de:Stauungspapille]]
[[it:Papilledema]]




[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Medical signs]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
 
[[Category:Intensive care medicine]]
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Latest revision as of 18:08, 11 June 2015

Papilledema
Papilledema.
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

Papilledema

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Papilledema from other Diseases

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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For patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]

Synonyms and Keywords: Papilloedema

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Papilledema from other Diseases

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

Template:WikiDoc Sources

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