Bilateral papilloedema secondary to central venous outflow obstruction in a haemodialysis patient: a case report

Central venous stenosis is a common complication of vascular access in haemodialysis patients, often resulting in venous hypertension and inadequate dialysis. Intracranial hypertension is a rare but serious and potentially reversible manifestation of central venous outflow obstruction. We report the case of a haemodialysis patient who presented with right-sided periorbital oedema and bilateral papilloedema, a key sign of raised intracranial pressure. Extensive evaluation revealed central venous outflow obstruction due to an occlusion at the brachiocephalic vein junction and severe proximal right internal jugular vein stenosis, resulting in impaired cerebral venous drainage and intracranial hypertension. Percutaneous transluminal angioplasty led to complete resolution of the papilloedema. This case highlights the importance of early recognition of central venous-obstruction related intracranial hypertension in haemodialysis patients and initiating prompt intervention to prevent irreversible visual loss.