Abstract

Papilledema is a disease entity that refers to the swelling of the optic disc due to elevated ICP.It can be a red flag suggesting disease entities that cause elevated ICP .
35-year-old lady presented with complaints of insidious onset, persistent, progressive holo-cranial throbbing headache with bilateral DOV and transient visual obscuration for 6 months. On fundus examination showed grade-5 papilloedema. Neurological opinion suggested that there was no any focal neurological deficit. MRI Brain showed Sella is filled with CSF, pituitary gland is seen lying along the floor of sella, increased CSF signal intensity in sheath of bilateral optic nerve suggestive of Idiopathic Intracranial Hypertension(IIH). Bilateral optic nerves are tortuous with prominent subarachnoid spaces around bilateral optic nerves & stenosis of lateral part of bilateral transverse sinuses. Patient was initially managed medically then left sinus transverse stenting was done which results in improvement of symptoms.