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Related Experiment Videos

Papilledema as a 'false' localizing sign.

Giuseppe Mariniello1, Giulio Bonavolontà, Enrico de Divitiis

  • 1Department of Neurosurgery, School of Medicine, Federico II University, 5 Via S. Pansini, 80131, Naples, Italy. g.mariniello@tin.it

Clinical Neurology and Neurosurgery
|January 17, 2002
PubMed
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Unilateral papilledema, often indicating increased intracranial pressure, can be a misleading sign for brain tumor location. This case highlights how a meningioma caused swelling in the opposite eye, not the affected one.

Area of Science:

  • Neuro-oncology
  • Ophthalmology
  • Neurosurgery

Background:

  • Progressive visual loss can be caused by various neurological conditions.
  • Papilledema is a key indicator of increased intracranial pressure.
  • Brain tumors, such as meningiomas, can present with atypical symptoms.

Observation:

  • A 47-year-old woman experienced 3 months of worsening vision in her right eye.
  • Fundus examination showed a normal right eye but severe papilledema in the left optic nerve.
  • Magnetic resonance imaging (MRI) identified a large right-sided 'en plaque' meningioma.

Findings:

  • Surgical removal of the right meningioma via pterional craniotomy was successful.
  • The case demonstrated that unilateral papilledema can be a 'false localizing sign'.

Related Experiment Videos

  • Tumor location was not indicated by the papilledema in the contralateral eye.

    • Implications:

    • Unilateral papilledema provides limited information for localizing intracranial masses.
    • Clinicians should consider 'false localizing signs' in neurological examinations.
    • Prompt diagnosis and surgical intervention are crucial for managing meningiomas and preserving vision.