Disc Oedema in A Patient with Chronic Kidney Disease: A Diagnostic Conundrum.
Jagadeesh SutrayeMohan KannamSrinivasa Perraju PonnapalliVirender SachdevaPublished in: Neuro-ophthalmology (Aeolus Press) (2021)
A 47-year-old woman who presented with headache and blurring of vision was referred to us due to suspicion of idiopathic intracranial hypertension or cerebral sinus venous thrombosis. She had chronic kidney disease and underwent dialysis through multiple ports including the right internal jugular vein (IJV). Her examination showed a best corrected visual acuity of 20/20 in each eye, normal anterior segments in each eye but bilateral papilloedema. Magnetic resonance imaging and venography (MRV) of her brain with contrast showed signs of raised intracranial pressure and a hypoplastic left transverse sinus. An MRV of her neck showed a thrombosis of the right IJV. Her symptoms and papilloedema resolved with carbonic anhydrase inhibitors and anticoagulants. This case highlights an uncommon presentation of papilloedema secondary to raised intracranial pressure from IJV thrombosis and its pathogenesis.
Keyphrases
- chronic kidney disease
- end stage renal disease
- magnetic resonance imaging
- case report
- pulmonary embolism
- optic nerve
- blood pressure
- peritoneal dialysis
- magnetic resonance
- contrast enhanced
- cerebral ischemia
- subarachnoid hemorrhage
- white matter
- sleep quality
- multiple sclerosis
- optical coherence tomography
- ultrasound guided
- physical activity
- diffusion weighted imaging