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Papilledema

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  1. Signs
    1. Early and mild Papilledema
      1. Subtle gray peripapillary halo
        1. Normal radial Optic Nerve head disrupted
        2. Nerve fibers accentuated by grayish opacity
      2. Concentric folds of the retinochoroid
    2. Moderate Papilledema
      1. Borders of optic disc become obscure
      2. Disc margins are progressively elevated
      3. Nerve head diameter increases
      4. Major blood vessels leaving the disc are obscured
    3. Severe Papilledema
      1. Optic Nerve head protrudes
      2. Peripapillary halo demarcated
      3. Optic cup is obliterated
  2. Associated findings
    1. Loss of spontaneous retinal vein pulsations
      1. Pulsations disappear at CSF Pressure > 250 mm water
      2. Unreliable sign
        1. Many normal patients lack venous pulsations
    2. Hyperemia
    3. Retinal vessel tortuosity
    4. Retinal hemorrhages
    5. Retinal exudates
    6. Nerve fiber infarctions (cotton wool spots)
    7. Optic Nerve pallor
  3. Interpretation
    1. Suggests increased Intracranial Pressure
  4. Causes: Pseudopapilledema
    1. Optic disc drusen
    2. Tilted optic disc
  5. Diagnostics
    1. Stereoscopic indirect fundoscopy
    2. Optic Nerve ultrasound
      1. Drusen are highly reflective
      2. Papilledema shows a distended Optic Nerve sheath

Papilledema (C0030353)

Definition (MSH)Swelling of the OPTIC DISK, usually in association with increased intracranial pressure, characterized by hyperemia, blurring of the disk margins, microhemorrhages, blind spot enlargement, and engorgement of retinal veins. Chronic papilledema may cause OPTIC ATROPHY and visual loss. (Miller et al., Clinical Neuro-Ophthalmology, 4th ed, p175)
Definition (CSP)swelling of the optic disk, usually in association with increased intracranial pressure, characterized by hyperemia, blurring of the disk margins, microhemorrhages, blind spot enlargement, and engorgement of retinal veins.
Definition (NCI)(pap-il-eh-DEE-ma) Swelling around the optic disk, the area where the optic nerve (the nerve that carries messages from the eye to the brain) enters the eyeball. Papilledema occurs when increased brain pressure caused by tumors or other problems results in swelling of the optic nerve.
Definition (NCI)Swelling around the optic nerve, usually due to pressure on the nerve by a tumor.
ConceptsFinding (T033)
ICD9377.0, 377.00
MSHD010211
EnglishBlurring of optic disc, Blurring of optic disk, Choked disc, Choked Disk, Choked Disks, Optic disc edema, Optic Disc Edema Adverse Event, Optic disc oedema, Optic disc swelling, Optic disc swollen, OPTIC DISCS BLURRED, Optic Disk Edema, Optic Disk Edemas, Optic Papilla Edema, Optic Papilla Edemas, Papilledema, Papilledemas, Papilloedema, Unspecified papilledema, Unspecified papilloedema
Spanishborramiento de papila optica, desdibujamiento del disco optico, disco estrangulado, edema de la papila optica, edema de papila, edema de papila optica, edema del disco optico, papiledema, papiledema no especificado, tumefaccion de la papila optica
Parent ConceptsDisorder of the optic nerve (C0029132), Cranial nerve diseases (C0010266), Papilledema (C0030353), Disorders of optic nerve and visual pathways (C1533675), Edema (C0013604), Adverse Event Associated with Ocular and Visual Systems (C1557306), Retinal Edema (C0242420), Optic disc finding (C0423451), Optic Disk Disorders (C0751402), Ambiguous concept (C1274012), Papilledema - optic disc edema due to raised intracranial pressure (C1828119)
SourcesCOSTAR, CSP, CST, DXP, ICD9CM, MSH, MTH, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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