Over a third of confirmed papilledema cases had a secondary intracranial cause.
Neuroimaging outcomes in suspected papilledema.
Theresia Knoche … Leon Alexander Danyel
Scientific reports · 2026
Background
Papilledema due to elevated intracranial pressure may indicate life-threatening conditions such as intracranial mass lesions or cerebral sino-venous thrombosis.
Purpose
This bicentric retrospective cohort study evaluated neuroimaging outcomes and clinical predictors in adults presenting with suspected papilledema to emergency departments between 2009 and 2022.
35.5%
Results
35.5%
over a third had a deeper, more serious brain cause found
n = 225 patients
More results
Clinical features, visual acuity, and frequency of focal neurological deficits were compared between groups.
Papilledema was excluded in 73 patients (32.4%).
Primary CT and MRI identified secondary pathology in 13.3% (number needed to scan 7.5) and 16.7% (number needed to scan 6) of patients, respectively.
More results
Diplopia, nausea/vomiting, and focal neurological deficits were associated with secondary causes but were not consistently present.
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Conclusion
Given the limited discriminatory value of clinical features, timely neuroimaging should be performed in the diagnostic evaluation.