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Papilledema after acute head injury
Neurosurgery
|March 1, 1985
Summary
Low grade papilledema can occur after severe head injury, often indicating milder trauma and better outcomes. This finding suggests papilledema is a potential indicator of less severe traumatic brain injury.
Area of Science:
- Neuroscience
- Ophthalmology
Background:
- Traumatic brain injury (TBI) can lead to various complications.
- Papilledema, swelling of the optic disc, is a known sign of increased intracranial pressure.
Observation:
- Low grade papilledema was observed in 3.5% of patients following acute, severe head injury.
- Papilledema onset varied, appearing immediately, within the first week, or later.
- Computed tomography scans revealed brain injury in most affected patients.
Findings:
- Intracranial pressure (ICP) was mildly to moderately elevated and controllable in patients with papilledema.
- Papilledema timing correlated with ICP patterns: sudden increases for immediate onset, sustained elevations for later onset.
- Patients with papilledema had higher Glasgow Coma Scores and no fatalities, suggesting less severe TBI compared to non-papilledema cases.
Implications:
- Papilledema in TBI patients may indicate a less severe injury with a favorable prognosis.
- The absence of papilledema in non-survivors with extreme ICP suggests trauma severity can prevent its development.
- Further research into papilledema as a prognostic marker in TBI is warranted.