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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  = |
  eMedicineTopic = |
  MeshID        = D010211 |
}}
}}
{{Search infobox}}
{{Papilledema}}
{{CMG}}; '''Associate Editor-In-Chief:''' Kalsang Dolma, MBBS
'''For patient information, click [[Papilledema (patient information)|here]]'''


'''''Synonyms and Keywords:''''' papilloedema
{{CMG}}; {{AE}} {{KD}}


== Overview ==
'''''Synonyms and Keywords:''''' Papilloedema
Papilledema is defined as swelling of the [[optic disc]] that is caused by increased [[intracranial pressure]]. The swelling is usually bilateral and can occur over a period of hours to weeks.


==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]]==


==Causes==
==[[Papilledema pathophysiology|Pathophysiology]]==


==Common Causes==
==[[Papilledema causes|Causes]]==
[[ Hydrocephalus]]


[[Cerebral edema]]
==[[Papilledema differential diagnosis|Differentiating Papilledema from other Diseases]]==


[[Intracranial bleeding]]
==[[Papilledema epidemiology and demographics|Epidemiology and Demographics]]==


[[ Brain tumor]]
==[[Papilledema Natural History, Complications and Prognosis|Natural History, Complications and Prognosis]]==


[[Cerebral venous sinus thrombosis]]
==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]]
[[Idiopathic intracranial hypertension]]
 
[[Optic neuritis]]
 
[[Optic neuropathy]]
 
[[Choroid plexus neoplasm]]
 
[[Hypertension]]
 
==Causes by Organ System==


{|style="width:80%; height:100px" border="1"
==Treatment==
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
[[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]]
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Hypertension]], [[Hypertensive encephalopathy]], [[Hypertensive retinopathy]]
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| [[Methanol]], [[Ethylene glycol]]
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Cisplatin]], [[Corticosteroid]], [[Growth hormone treatment]], [[Insulin-like growth factor 1]], [[Interleukin 11]], [[Isotretinoin]], [[Lithium]], [[Minocycline]], [[Tetracycline]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Cushing's disease]], [[Diabetic retinopathy]], [[Thyroid opthalmopathy]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Acute liver failure]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Camurati - Engelmann disease]], [[Crouzon syndrome]], [[Fabry's Disease]], [[Tuberous sclerosis]], [[Vogt-Koyanagi-Harada syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Acute lymphocytic leukemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Brucellosis]], [[Epidural abscess]], [[Infective endocarditis]], [[Meningitis]], [[Meningoencephalitis]], [[Paragonimiasis]], [[Syphillis]], [[Toxoplasmosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| [[Paget's disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Cavernous Sinus Thrombosis]], [[Arachnoid cyst]], [[Arnold chiari malformation]], [[Brain Abscess]], [[Brain cyst]], [[Brown - symmers disease]], [[Cerebellar abscess]],
[[Cerebral abscess]], [[Cerebral venous sinus thrombosis]], [[Dandy-Walker syndrome]], [[Epidural hematoma]], [[Foster kennedy syndrome]], [[Intracranial bleeding]]
[[Medulloblastoma]], [[Myoclonic epilepsy]], [[Parinaud's syndrome]], [[Subarachnoid hemmorhage]], [[Subdural empyema]], [[Subdural hematoma]], [[ Hydrocephalus]], [[Cerebral edema]], [[Gullian-Barre syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| [[Nutritional optic neuropathy]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Eclampsia]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"|[[Adult low grade infiltrative suoratentorial astrocytoma]], [[Brain Stem Gliomas]], [[Brain tumor]], [[Chondroma]], [[Choroid plexus neoplasm]], [[Malignant Astrocytomas]], [[Neuroectodermal tumor primitive]], [[Osteoma]], [[Tumor lysis syndrome]], [[Acute lymphocytic leukemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| [[Amaurosis fugax]], [[Chorioretinitis]], [[Glaucoma]], [[Neuropapillitis]], [[Optic disc drusen]], [[Optic disc vasculitis]], [[Optic neuritis]], [[Orbital lesion]], [[Orbital optic nerve tumors]], [[Papillitis]], [[Scleritis]], [[Age related macular degeneration]], [[Anterior ischemic optic neuropathy]], [[Central retinal vein occlusion]], [[Optic neuropathy]]
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| [[Arsenicals]], [[Carbon monoxide toxity]], [[Ethylene glycol]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Hypercapnia]], [[Obesity hypoventilation syndrome]], [[Respiratory acidosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| [[Acid Base Imbalance]], [[Hypocalcemic tetany]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Sarcoidosis]], [[Sympathetic ophthalmia]], [[Systemic Lupus Erythematosus]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Head trauma]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[Idiopathic intracranial hypertension]], [[POEMS syndrome]], [[Deafness- peripheral- neuropathy- arterial disease]]
|-
|}


===Causes in Alphabetical Order ===
== Case Studies ==
 
[[Papilledema case study one|Case #1]]
{{MultiCol}}
* [[Acid Base Imbalance]]
 
* [[Acute liver failure]]
 
* [[Acute lymphocytic leukemia]]
 
* [[Adult low grade infiltrative suoratentorial astrocytoma]]
 
* [[Age related macular degeneration]]
 
* [[Amaurosis fugax]]
 
* [[Anterior ischemic optic neuropathy]]
 
* [[Arachnoid cyst]]
 
* [[Arnold chiari malformation]]
 
* [[Arsenicals]]
 
* [[Brain Abscess]]
 
* [[Brain cyst]]
 
* [[Brain Stem Gliomas]]
 
* [[Brain tumor]]
 
* [[Brown - symmers disease]]
 
* [[Brucellosis]]
 
* [[Camurati-Engelmann disease]]
 
* [[Carbon monoxide toxity]]
 
* [[Cavernous Sinus Thrombosis]]
 
* [[Central retinal vein occlusion]]
 
* [[Cerebellar abscess]]
 
* [[Cerebral abscess]]


==Related Chapters==
* [[Cerebral edema]]
* [[Cerebral edema]]
 
* [[Intracranial pressure]]
* [[Cerebral venous sinus thrombosis]]
* [[Raised intracranial pressure]]
 
* [[Chondroma]]
 
* [[Chorioretinitis]]
 
* [[Choroid plexus neoplasm]]
 
* [[Cisplatin]]
 
* [[Corticosteroid]]
 
* [[Crouzon syndrome]]
 
* [[Cushing's disease]]
 
* [[Dandy-Walker syndrome]]
 
* [[Deafness- peripheral- neuropathy- arterial disease]]
 
* [[Diabetic retinopathy]]
 
* [[Eclampsia]]
 
* [[Epidural abscess]]
 
* [[Epidural hematoma]]
 
* [[Ethylene glycol]]
 
* [[Fabry's Disease]]
 
* [[Foster Kennedy syndrome]]
 
* [[Glaucoma]]
 
* [[Growth hormone treatment]]
 
* [[Gullian-Barre syndrome]]
 
* [[Head trauma]]
 
* [[Hydrocephalus]]
 
* [[Hypercapnia]]
 
* [[Hypertension]]
 
{{ColBreak}}
 
* [[Hypertensive encephalopathy]]
 
* [[Hypertensive retinopathy]]
 
* [[Hypocalcemic tetany]]
 
* [[Idiopathic intracranial hypertension]]
 
* [[Infective endocarditis]]
 
* [[Insulin-like growth factor 1]]
 
* [[Interleukin 11]]
 
* [[Intracranial bleeding]]
 
* [[Isotretinoin]]
 
* [[Lithium]]
 
* [[Malignant Astrocytomas]]
 
* [[Medulloblastoma]]
 
* [[Meningitis]]
 
* [[Meningoencephalitis]]
 
* [[Methanol]]
 
* [[Minocycline]]
 
* [[Myoclonic epilepsy]]
 
* [[Neuroectodermal tumor primitive]]
 
* [[Neuropapillitis]]
 
* [[Nutritional optic neuropathy]]
 
* [[Obesity hypoventilation syndrome]]
 
* [[Optic disc drusen]]
 
* [[Optic disc vasculitis]]
 
* [[Optic neuritis]]
 
* [[Optic neuropathy]]
 
* [[Orbital lesion]]
 
* [[Orbital optic nerve tumors]]
 
* [[Osteoma]]
 
* [[Paget's disease]]
 
* [[Papillitis]]
 
* [[Paragonimiasis]]
 
* [[Parinaud's syndrome]]
 
* [[POEMS syndrome]]
 
* [[Respiratory acidosis]]
 
* [[Sarcoidosis]]
 
* [[Scleritis]]
 
* [[Subarachnoid hemmorhage]]
 
* [[Subdural empyema]]
 
* [[Subdural hematoma]]
 
* [[Sympathetic ophthalmia]]
 
* [[Syphillis]]
 
* [[ Systemic Lupus Erythematosus]]
 
* [[Tetracycline]]
 
* [[Thyroid opthalmopathy]]
 
* [[Toxic optic neuropathy]]
 
* [[Toxoplasmosis]]
 
* [[Tuberous sclerosis]]
 
* [[Tumor lysis syndrome]]
 
* [[Vogt-Koyanagi-Harada syndrome]]
 
{{EndMultiCol}}
 
==Differentiation of Papilledema from other Disorders==
Papilledema should be distinguished from [[pseudopapilledema]] which is caused by
*Optic disc drusen
*Tilted [[optic disc]]
 
==Epidemiology and Demographics==
Papilledema occurs in approximately 50% of those with a [[brain tumour]].
 
==Diagnosis==
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.
 
=== Physical Examination ===
==== Eyes ====
[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]
 
<div align="left">
<gallery heights="175" widths="175">
Image:Papilledema 1.jpg|Papilledema.
Image:Pseudopapilledema.jpg|Pseudopapilledema.
</gallery>
 
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]]
 
==References==
{{Reflist|2}}


{{Eye pathology}}
{{Eye pathology}}


[[de:Stauungspapille]]
[[it:Papilledema]]


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[[Category:Medical signs]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Intensive care 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

Papilledema On the Web

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American Roentgen Ray Society Images of Papilledema

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Ongoing Trials at Clinical Trials.gov

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Blogs on Papilledema

Directions to Hospitals Treating Papilledema

Risk calculators and risk factors for Papilledema

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

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