♠The purpose of our educational exhibit is to: Review key anatomical structures,
pathologic mechanism and clinical implication of papilledema Describethe key MRI findings of papilledema Review several causes of increased intracranial pressureand papilledema,
with some cases. Emphasize the role of transverse venous sinus stenting in patients with idiopathic intracranial hypertension and transverse sinus stenosis.
1.Definition of papilledema Optic disc swelling associated with increased intracranial pressure (ICP) 2.
Fundoscopic findings of papilledema(Fig.1) Optic disc swelling with blurred margin Disc hyperemia Peripapillary hemorrhage Venous engorgement 3.
Key anatomic structures associated with papilledema Perioptic meninges - Envelope the length of the optic nerve up to the globe and continuous with intracranial meninges Subarachnoid space of the optic nerve - Multichambered tubular system with...
Findings and procedure details
♠ Key MR imaging findings of papilledema 1.
Widening of optic nerve sheath Normal optic nerve sheath
- Diameter Just behind the globe: 5.52± 1.11 mm 4 mm posterior to the globe : 5.2 ± 0.9 mm Bulbous appearance at just behind the globe
- Most distensible part of the optic nerve sheath Diameter of optic nerve sheath is a strong indicator of increased ICP Optic nerve sheath enlargement in papilledema (Fig.4,
5) - Appears as widened ring of CSF around an optic nerve on coronal images
♠ Summary Papilledema is optic disc swelling associated with intracranial pressure (ICP) Early detection of papilledema is important because it could be indicator of increased ICP and could lead to visual impairment and even blindness by itself There are some key MRI findings which represent the papilledema
1) Widening of optic nerve sheath
2) Flattening of posterior sclera
3) Optic disc protrusion into globe
4) Tortuosity of optic nerves There are some etiologies which could cause the...
MR imaging of papilledema and visual pathways: effects of increased intracranial pressure and pathophysiologic mechanisms.
AJNR Am J Neuroradiol 2013;34:919-924 2.
Pseudotumor cerebri: brief review of clinical syndrome and imaging findings.
AJNR Am J Neuroradiol 2011;32:1986-1993 3.
Transverse sinus stenting for idiopathic intracranial hypertension: a review of...