What is Papilledema?
This is a medical condition where the head of the optic nerves, referred to as the optic disc, becomes inflamed. The optic nerve is what connects the brain tissue with the farthest back tissue of the eye which is called the retina. In addition, these are the nerves that are responsible for relaying any messages between your eyes and your brain. Papilledema can happen over a time frame of hours to weeks. It usually happens bilateral which means it happens in both eyes. This is a condition that can be found in all age groups but it is fairly uncommon to find it in infants because the bones of their skulls are not fully fused together yet. Papilledema affects approximately two hundred thousand people in the United States. Papilledema may also be referred to as papillary stasis or choked disk. With chronic Papilledema a person could develop optic atrophy which is a dysfunction of your optic nerve that results in having impaired vision.
When a person first gets Papilledema there are few symptoms. Swelling of your optical nerve is not the only symptom. Here are some of the other symptoms of intracranial pressure that may occur include:
- Double vision
- Blurred vision
- Seeing flashes of gray
- Vision flickering that are often seen in an arc shape
- Reduced field of vision
- Nausea which can be made worse if you are bending, straining, or coughing
- Constant intense headaches which are worse when you wake up
- Farsightedness may increase.
- Hearing vascular noises, pulsatile tinnitus, or whooshing sounds because of increased intracranial pressure
- Cranial nerve palsies
In severe cases of Papilledema twenty-five percent of the people who have a severe case may experience:
- Short periods of seconds of losing vision, which is called transient visual obscurations. They usually last less than thirty seconds. They can happen when you are changing position or standing up.
- Response to light becomes abnormal
A common cause of this condition is a brain tumor, especially on the frontal lobe, in which force is applied to the skull. Another is an increase in the cerebrospinal fluid which is present between your brain and skull. These are the only causes that would make optic nerve inflammation to be called Papilledema. If it is caused by an inflammatory disease or infection it would not be Papilledema. Other causes might be:
- Direct trauma to the skull
- A rupture of the blood vessels that are surrounding your brain.
- Having meningitis, which is a bacterial infection that affects your brain and can cause skull pressure.
- Respiratory failure
- Guillian-Barre syndrome which is due to the elevated levels of protein associated with this medical condition
- Lyme disease, especially when the bacterial infection is in the central nervous system.
- Acute Lymphocytic Leukemia
- Tumors on the spinal column or cord, in the skull, or on the optic nerve
- Abscess on the brain
- Abnormal closure of the bones in your skull
- Accumulation of cerebrospinal fluid in your skull
- Certain medications such as tetracycline, vitamin A
- Steroids—especially if the amount you are taking changes
- Hypertension— very high blood pressure
- Pseudotumor cerebri—this is when your body makes excess spinal fluid which is more common in women of childbearing age or obese
There are some rare instances in which this condition can happen not from issues with your brain such as:
- High blood pressure which could cause your blood vessels near your optic nerve to swell.
- Fluctuating hormone levels in women from some birth control pills or being pregnant, going through menopause, or having their first menstrual cycle
This condition will usually be treated by treating what is causing the optical nerve to become inflamed. One of the first things that is done before any treatment is started is to take a biopsy to see what the cause is and to see if there is some type of tumor, especially in the brain. Some ways in which to treat pressure on your skull includes:
- Diuretic medication along with a weight loss program if the condition is caused by abnormally high cerebrospinal fluid production corticosteroids.
- Surgery to put in a shunt to allow the excess fluid to drain off
- Laser treatment, radiation, and surgery if it is a brain tumor causing this condition
- Lumbar punctures to remove any excess spinal fluid that is found in the cranium
- If the cause is extreme hypertension a person may be hospitalized.
- Medication called acetazolamide to treat the underlying cause if it is pseudotumor cerebri
These can include:
- Herbal remedies
Once the pressure on your skull is reduced your optic nerve will usually return to its normal size by eight weeks. If Papilledema is caused by pseudotumor cerebri, it can take a little longer for things to clear up. If the condition is not treated in time the optic nerve can become so swollen that there is not enough blood flow possibly resulting in damage to the optic nerve and lead to a total loss of vision. This is why it is very important to see your physician to get the right diagnosis and treatment early.
Photos, Images and Pictures of Papilledema…