Archives for June 2019

Neuro-ophthalmology Illustrated Chapter 9 – Disk Edema 3

Questions:
34. What are the symptoms and signs of idiopathic intracranial hypertension (IIH)?
35. What are the diagnostic criteria for IIH?
36. What is the ideal imaging test when evaluating a patient with presumed papilledema?
37. A patient with bilateral disc swelling has a normal brain MRI. What test should be done next?
38. What should one consider if the headaches of IIH do not improve (at least transiently) after a lumbar puncture?
39. What does a normal Brain MRI in the setting of papilledema suggest?
40. What should be evaluated next in a patient with bilateral swollen discs, normal BP, normal CT with and without contrast, LP opening pressure >250mm and normal or abnormal CSF contents?
41. What should be evaluated next in a patient with bilateral swollen discs, normal BP, normal MRI with and without contrast, LP opening pressure >250mm and normal or abnormal CSF contents? 
42. What items are most commonly associated with IIH?
43. What condition can mimic the symptoms of cerebral venous thrombosis?
44. What can early recognition of cerebral venous thrombosis prevent?
45. Should papilledema from a meningeal process or cerebral venous thrombosis be classified as IIH?
46. What are the goals of IIH management?
47. What are the main factors that drive the management of IIH?
48. What MRI findings are supportive of the diagnosis of IIH?
49. When the predominant symptom of a patient with IIH is severe headaches, which surgical procedure is preferred?
50. How often does a lumboperitoneal or ventriculoperitoneal shunt need to be repaired?
51. When the predominant symptom of a patient with IIH is vision loss and headaches are no more than mild, which surgical procedure is preferred?
52. Does optic nerve sheath fenestration usually need to be performed on both optic nerves?
53. How often does optic nerve sheath fenestration fail?

Neuro-ophthalmology Illustrated Chapter 9 – Disk Edema 2

Questions:
17. Once optic disc edema is confirmed, what should be determined?
18. In anterior optic neuropathy with disk edema, is visual acuity usually decreased?
19. In papilledema is visual acuity usually decreased?
20. In anterior optic neuropathy with disk edema is color vision usually decreased?
21. In papilledema is color vision usually decreased?
22. What are the usual characteristics of visual field defects in anterior optic neuropathy with disk edema?
23. What are the usual characteristics of visual field defects in papilledema
24. Is anterior optic neuropathy with disk edema usually unilateral?
25. Is papilledema usually unilateral?
26. What findings are often associated with papilledema?
27. Does the absence of disc edema rule-out raised intracranial pressure in a patient presenting with headache?
28. What visual symptoms are associated with papilledema?
29. When is central visual acuity loss experienced in papilledema, early or late?
30. What type of visual field defect is found initially with papilledema?
31. What type of visual field loss is experienced in long-standing papilledema?
32. Can visual loss from papilledema occur with any cause of papilledema?
33. What should be assessed next in a patient found to have papilledema?

Neuro-ophthalmology Illustrated Chapter 9 – Disk Edema 1

Questions:
1. What is the term reserved for optic disk swelling with increased intracranial pressure?
2. Does pseudoedema of the optic disk have elevated optic nerve head?
3. Does pseudoedema of the optic disk have sharp margins?
4. Does pseudoedema of the optic disk have obscured vessels?
5. Does pseudoedema of the optic disk have a central cup?
6. Does pseudoedema of the optic disk have anomalous retinal vasculature?
7. Does pseudoedema of the optic disk leak on FA?
8. Does pseudoedema of the optic disk have peripapillary hemorrhages and exudates?
9. Does pseudoedema of the optic disk have venous dilation and tortuosity? 10. Does true disc edema of the optic disk have elevated optic nerve head?
11. Does true disc edema of the optic disk have sharp margins?
12. Does true disc edema of the optic disk have obscured vessels?
13. Does true disc edema of the optic disk have venous dilation and tortuosity?
14. Does true disc edema of the optic disk have anomalous retinal vasculature?
15. Does true disc edema of the optic disk have peripapillary hemorrhages and exudates?
16. Does true disc edema of the optic disk leak on FA?

Neuro-ophthalmology Illustrated Chapter 8 – Optic Neuropathies 11

Questions:
130. What type of traumatic optic neuropathy may require emergent treatment?
131. What is the management of indirect traumatic optic neuropathy?
132. What should be done in all cases of head trauma?
133. What potential alternative causes of optic neuropathy should be ruled out when considering the diagnosis of low-tension glaucoma?
134. Are optic nerve head drusen usually unilateral or bilateral?
135. Do patients with optic nerve head drusen experience transient visual obscurations?
136. What are optic nerve head drusen?
137. What should be done if a patient presents with visual symptoms of optic neuropathy and is found to have optic nerve head drusen?
138. What is the most common congenital optic nerve anomaly?
139. What are the characteristics of optic nerve hypoplasia?
140. What conditions are associated with optic nerve hypoplasia?
141. What is an optic disk coloboma?
142. What conditions are associated with optic disk coloboma?
143. What are the characteristics of the “morning glory” disk anomaly?
144. What is the mechanism behind the morning glory disk anomaly?
145. What conditions are associated with the “morning glory” disk anomaly?
146. What is the mechanism of optic pit development?
147. What are the characteristics of an optic pit?
148. What are the characteristics of the tilted disk anomaly?
149. What is the usual field defect seen with myelinated retinal nerve fibers around the disk?