Symptoms may be fleeting disturbances in vision, headache, vomiting, or a combination.
Doctors make the diagnosis by looking in the person’s eye with an ophthalmoscope.
The disorder causing increased brain pressure is treated as soon as possible.
(See also Overview of Optic Nerve Disorders Overview of Optic Nerve Disorders The small photoreceptor cells of the retina (the inner surface at the back of the eye) sense light and transmit impulses to the optic nerve. The optic nerve from each eye carries impulses to... read more .)
Causes of Papilledema
Papilledema is usually caused by the following:
Bleeding in the brain
Inflammation of the brain (encephalitis Encephalitis Encephalitis is inflammation of the brain that occurs when a virus directly infects the brain or when a virus, vaccine, or something else triggers inflammation. The spinal cord may also be involved... read more ) or its tissue coverings (meningitis Meningitis read more )
These conditions typically result in papilledema in both eyes.
Symptoms of Papilledema
At first, papilledema may be present without affecting vision. Fleeting vision changes—blurred vision, double vision, flickering, or complete loss of vision—typically lasting seconds are characteristic of papilledema. Other symptoms may be caused by the elevated pressure in the brain. Headache, nausea, vomiting, or a combination may occur. This disorder does not cause pain.
Diagnosis of Papilledema
A doctor's evaluation
Lumbar puncture (spinal tap)
To diagnose papilledema, a doctor uses an ophthalmoscope (a light with magnifying lenses that is used to look into the back of the eye). Often an ophthalmologist (a medical doctor who specializes in the evaluation and treatment of eye disorders) needs to confirm the diagnosis and help determine the cause.
Magnetic resonance imaging (MRI) or computed tomography (CT) may be used to help determine the cause and monitor the effect of treatment.
A lumbar puncture Spinal Tap Diagnostic procedures may be needed to confirm a diagnosis suggested by the medical history and neurologic examination. Electroencephalography (EEG) is a simple, painless procedure in which... read more (spinal tap) is done to measure the pressure of the cerebrospinal fluid unless something is seen on the MRI or CT scan indicating a spinal tap is not safe to do. A sample of the cerebrospinal fluid may be examined for evidence of a brain tumor or infection.
Sometimes ultrasonography of the eye is done to distinguish between papilledema and other disorders that cause apparent swelling of the optic nerve.
Treatment of Papilledema
Treatment of cause
The disorder causing increased brain pressure is treated as soon as possible. For example, if the high pressure of the cerebrospinal fluid is caused by a brain tumor Overview of Brain Tumors A brain tumor can be a noncancerous (benign) or cancerous (malignant) growth in the brain. It may originate in the brain or have spread (metastasized) to the brain from another part of the body... read more , corticosteroids may be given, but surgery to remove the tumor or radiation therapy to decrease its size may be needed.
Papilledema that occurs as a result of idiopathic intracranial hypertension can be treated with weight loss and a diuretic. If unsuccessful, surgical procedures can be done.
An infection, if bacterial, can be treated with antibiotics.
A brain abscess is drained, and antibiotics are given.