Re: Re: Raised intracranial pressure in those presenting with headache
Dear Editor,
re: Raised intracranial pressure in patients with headache, Mollan et al. BMJ 6th October 2018 p. 36
I was concerned to read the account of a young woman with increasing headache and visual disturbances who was admitted for investigation. The summary states that her fundi were examined with an ophthalmoscope on day 8 of her admission, following more extensive investigations, and it was then that papilloedema was discovered.
Surely with such a history examination of the fundi should have been an immediate priority, and if for any reason there were difficulties, a word with the ophthalmic team would have been the next step. The authors in their discussion are clearly aware of the frequency with which neurology inpatients fail to have their fundi examined, but why such a rapid and cost free examination was not part of the admission routine is not explained.
Times have clearly changed, and papilloedema is easily missed if not looked for.
Rapid Response:
Re: Re: Raised intracranial pressure in those presenting with headache
Dear Editor,
re: Raised intracranial pressure in patients with headache, Mollan et al. BMJ 6th October 2018 p. 36
I was concerned to read the account of a young woman with increasing headache and visual disturbances who was admitted for investigation. The summary states that her fundi were examined with an ophthalmoscope on day 8 of her admission, following more extensive investigations, and it was then that papilloedema was discovered.
Surely with such a history examination of the fundi should have been an immediate priority, and if for any reason there were difficulties, a word with the ophthalmic team would have been the next step. The authors in their discussion are clearly aware of the frequency with which neurology inpatients fail to have their fundi examined, but why such a rapid and cost free examination was not part of the admission routine is not explained.
Times have clearly changed, and papilloedema is easily missed if not looked for.
Yours sincerely,
Dr Alex Norris, FRCP
Competing interests: No competing interests