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Current Neurology and Neuroscience Reports

, Volume 12, Issue 3, pp 334–339 | Cite as

Papilledema: Are We Any Nearer to a Consensus on Pathogenesis and Treatment?

  • Andrew G. LeeEmail author
  • Michael Wall
Neuro-Ophthalmology (G Plant, Section Editor)

Abstract

Papilledema is a term generally reserved (at least in the English language use of the term) by neuro-ophthalmologists for optic disc edema due to increased intracranial pressure. The etiology for the intracranial hypertension may be known (e.g., brain tumor, meningitis, cerebral venous sinus thrombosis) or may be idiopathic (idiopathic intracranial hypertension [IIH]). IIH is a disorder that predominantly affects overweight women of childbearing age and these epidemiologic factors should offer clues to pathogenesis. The main morbidity of papilledema is visual loss and the major mechanism for permanent optic nerve damage is axoplasmic flow stasis and resultant intraneuronal ischemia. The current initial management of papilledema in IIH includes weight loss and medical therapy (e.g., acetazolamide or furosemide). Patients who fail, are intolerant to, or noncompliant with maximum tolerated medical therapy might require optic nerve sheath fenestration or cerebrospinal fluid diversion (i.e., shunting) procedures.

Keywords

Papilledema Pseudotumor cerebri Idiopathic intracranial hypertension Visual loss Cerebral venous sinus thrombosis Venous stenting 

Notes

Disclosure

Conflicts of interest: A.G. Lee: none; M. Wall: has received grant support from the IIHTT.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of OphthalmologyThe Methodist HospitalHoustonUSA
  2. 2.The Departments of Ophthalmology, Neurology and Neurosurgery, Weill Cornell Medical CollegeThe Methodist HospitalHoustonUSA
  3. 3.The Department of NeurologyUniversity of Iowa Hospitals and ClinicsIowa CityIowa
  4. 4.OphthalmologyThe University of Iowa Hospitals and ClinicsIowa CityIowa
  5. 5.OphthalmologyBaylor College of MedicineHoustonUSA
  6. 6.OphthalmologyThe University of Texas Medical BranchGalvestonUSA

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