THE DIAGNOSTIC-VALUE OF OPTIC DISC EVALUATION IN ACUTE ELEVATED INTRACRANIAL-PRESSURE

Purpose: Ophthalmologists often are asked to evaluate the optic disc f or evidence of acute increased intracranial pressure (ICP). The author s studied the incidence of papilledema in a population of patients wit h a documented acute increase in ICP. Methods: Included in this study were 37 patients with acute elevated ICP due to a spontaneous hemorrha ge or craniocerebral trauma. In all patients, the ICP was monitored co ntinuously. Fundus examination was performed twice daily on at least 7 consecutive days. Results: According to the level and duration of the ICP, the patients were divided into three groups. Group 1 included 13 patients who had a slightly elevated ICP (range, 20-30 mmHg) on at le ast 3 consecutive days, In this group, 3 of 13 patients demonstrated v enous congestion on the fifth or sixth day, No swelling of the optic d isc was seen in this group. Group 2 included seven patients with an el evated ICP, with values ranging from 30 to 70 mmHg lasting for at leas t 3 consecutive days. In this group, one patient had a blurred disc ma rgin on the sixth day. Group 3 included 17 patients with shortlasting ICP values, ranging from 30 to 60 mmHg for less than 72 hour, Neither papilledema nor abnormalities of fundus vessels were seen in this grou p. Conclusion: Papilledema in acute elevation of ICP is an uncommon ev ent. Its absence does not preclude the presence of ICP elevation.