Long-term evolution of papilledema in idiopathic intracranial hypertension: observations concerning two cases.
Chronic headaches, associated with papilledema and pulsatile tinnitus without any neuroradiologic, cytobiochemical or cerebrospinal fluid abnormalities are suggestive of idiopathic intracranial hypertension (IIH). However the absence of the papilledema does not rule out this diagnosis. The reason why some patients do not develop papilledema in IIH is ignored, however there are some hypotheses concerning the structure of the optical nerve. In this study we described two female patients that presented diagnosis of IIH with papilledema, with subsequent resolution of papilledema without the due resolution of intracranial hypertension. The long-term behavior of the optic nerve (ON) facing an increased intracranial pressure was evaluated through repeated measurements of the intracranial pressure. We concluded that the ON submitted to high intracranial pressure for a certain length of time can adapt itself with subsequent disappearance of the papilledema. The presence or not of papilledema in IIH can be related to the period in which the diagnosis is accomplished.
Neurology Unit, Internal Medicine Department, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil. piovesan@avalon.sul.com.br
Elcio Juliato
EJ
Piovesan
Marcos Cristiano
MC
Lange
Liciane do Rocio Maia
Ldo R
Piovesan
Sergio Monteiro
SM
de Almeida
Pedro André
PA
Kowacs
Lineu Cesar
LC
Werneck
D000328:Adult; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D009900:Optic Nerve / Q000503:physiopathology; D010211:Papilledema / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D011559:Pseudotumor Cerebri / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D013997:Time Factors