Neuroimaging outcomes in suspected papilledema.

Cohort studyScientific reports· May 2026

Neuroimaging outcomes in suspected papilledema.

Theresia Knoche, Nehir Guelsoy, Charlotte Pietrock … Leon Alexander Danyel

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Neuro-ophthalmologyCohort studyDiagnosisQ1IF 5.0

Over a third of confirmed papilledema cases had a secondary intracranial cause.

Neuroimaging outcomes in suspected papilledema.

Theresia Knoche … Leon Alexander Danyel

Scientific reports · May 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.

“

Conclusion

Given the limited discriminatory value of clinical features, timely neuroimaging should be performed in the diagnostic evaluation.

Neuroimaging outcomes in suspected papilledema.

Neuroimaging outcomes in suspected papilledema.

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