Hypothesis may explain clinical scenarios in increased ICP

Editor's Note: Sherif Amer, MD, proposes a new hypothesis for pressure dissociation in optic disc edema due to increased intracranial pressure (ICP) (i.e., papilledema). This theory provides some insight into some of the clinically controversial scenarios that occur in increased ICP such as pseudotumor cerebri without papilledema, asymmetric or frankly unilateral papilledema, and progressive visual loss due to increased ICP without disc edema. The theory has merit and deserves further study and testing of the hypotheses generated. -- Andrew G. Lee, MD