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Aetiology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Papilloedema results from raised intracranial pressure in which the subarachnoid space surrounding the optic nerve is patent, i.e. papilloedema is not a necessary consequence of raised intracranial pressure.

The most common situations are:

  • intracranial space-occupying lesions - tumours, especially of the posterior fossa; cerebral abscesses; subdural haematoma
  • any condition causing hydrocephalus in an adult, e.g. subarachnoid haemorrhage, meningitis, head injury
  • venous obstruction - especially due to venous sinus thrombosis
  • benign intracranial hypertension - most likely in patients with visual complaints but otherwise normal
  • malignant hypertension - bilateral with other signs of hypertensive neuropathy
  • central retinal venous occlusion, ischaemic optic neuropathy, optic neuritis - unilateral with sudden loss of vision
  • chronic carbon dioxide retention

Other rare causes include:

  • metabolic:
    • hypoparathyroidism
    • diabetic ketoacidosis
    • chronic carbon dioxide retention
    • obesity
  • haematological - anaemia, leukaemia
  • toxic - tetracycline, lead, oral progestational agents, corticosteroid withdrawal
  • spinal cord tumours, perhaps due to high CSF protein levels

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