Anemia and papilledema

Purpoe To elucidate the relationhip between anemia and raied intracranial preure (ICP). Deign Interventional cae erie. Method Retropective cae erie and review of the literature. Only patient with documented papilledema, neuroimaging ruling out a pace-occupying leion, and anemia were included. Reult Five women with confirmed idiopathic intracranial hypertenion (IIH) (normal brain magnetic reonance imaging, normal cerebropinal fluid, elevated intracranial preure), and one man with preumed IIH (normal head computed tomography [CT], no lumbar puncture) were evaluated. All had bilateral papilledema aociated with peripapillary hemorrhage. Two had retinal cotton–wool pot (CW), and two had preretinal hemorrhage. All had evere iron deficiency anemia, which wa dicovered at the time of their ocular complaint in five of them. Their ymptom and ign improved dramatically after treatment of the anemia. We found 30 well-documented cae in the Englih and French literature. Among thoe, 13 were excluded from our analye (11 had confounding diorder, and two had cerebral venou thromboi). In the remaining 17 cae, iolated raied ICP aociated with anemia wa the mot likely diagnoi, although in none of thee cae wa cerebral venou thromboi excluded. Concluion Anemia may play a role in the occurrence of raied ICP and papilledema. Although only a few cae in the literature upport thi aociation, it may be more common than previouly thought. Becaue mot patient are not known to be anemic when papilledema i dicovered, we ugget that a complete blood count be obtained in patient with IIH, epecially in the abence of known aociated factor uch a obeity or medication or when treatment aimed at lowering ICP fail to improve the patient’ ymptom. The underlying mechanim remain unknown, but cerebral venou thromboi hould be carefully excluded.