{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:03:24Z","timestamp":1779840204700,"version":"3.53.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002839","name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002839","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Papilledema due to elevated intracranial pressure may indicate life-threatening conditions such as intracranial mass lesions or cerebral sino-venous thrombosis. This bicentric retrospective cohort study evaluated neuroimaging outcomes and clinical predictors in adults presenting with suspected papilledema to emergency departments between 2009 and 2022. Diagnostic outcomes were categorized as confirmed papilledema (due to idiopathic intracranial hypertension, space-occupying lesions, hydrocephalus or secondary intracranial causes) or papilledema ruled out. Clinical features, visual acuity, and frequency of focal neurological deficits were compared between groups. Diagnostic yield and number needed to scan (NNS) for CT and MRI were calculated, and univariable logistic regression was performed to identify predictors of secondary intracranial causes. Among 225 patients (mean age 43.0\u2009\u00b1\u200916.8 years; 57% female), papilledema was confirmed in 124 (55%), including 44 (35.5%) with secondary intracranial causes. Papilledema was excluded in 73 patients (32.4%). Primary CT and MRI identified secondary pathology in 13.3% (NNS 7.5) and 16.7% (NNS 6) of patients, respectively. Diplopia, nausea\/vomiting, and focal neurological deficits were associated with secondary causes but were not consistently present. Secondary intracranial pathology is common in suspected papilledema. Given the limited discriminatory value of clinical features, timely neuroimaging should be performed in the diagnostic evaluation.<\/jats:p>","DOI":"10.1038\/s41598-026-55133-4","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T23:03:27Z","timestamp":1779836607000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuroimaging outcomes in suspected papilledema"],"prefix":"10.1038","volume":"16","author":[{"given":"Theresia","family":"Knoche","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehir","family":"Guelsoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Pietrock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eberhard","family":"Siebert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Rossel-Zemkouo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohreh","family":"Jami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon Alexander","family":"Danyel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"55133_CR1","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1212\/01.CON.0000453314.75261.66","volume":"20","author":"DI 1 Friedman","year":"2014","unstructured":"1 Friedman, D. I. Papilledema and idiopathic intracranial hypertension. Continuum (Minneap Minn). 20, 857\u2013876. https:\/\/doi.org\/10.1212\/01.CON.0000453314.75261.66 (2014).","journal-title":"Continuum (Minneap Minn)"},{"key":"55133_CR2","doi-asserted-by":"publisher","unstructured":"2 Chang, M. Y. et al. Accuracy of Diagnostic Imaging Modalities for Classifying Pediatric Eyes as Papilledema Versus Pseudopapilledema. Ophthalmology 124, 1839\u20131848. https:\/\/doi.org\/10.1016\/j.ophtha.2017.06.016 (2017).","DOI":"10.1016\/j.ophtha.2017.06.016"},{"key":"55133_CR3","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1038\/s41433-019-0355-9","volume":"33","author":"RJ 3 Blanch","year":"2019","unstructured":"3 Blanch, R. J. et al. Detection of Papilloedema Study (DOPS): rates of false positive papilloedema in the community. Eye (Lond). 33, 1073\u20131080. https:\/\/doi.org\/10.1038\/s41433-019-0355-9 (2019).","journal-title":"Eye (Lond)"},{"key":"55133_CR4","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jaapos.2015.05.007","volume":"19","author":"JJ 4 Kovarik","year":"2015","unstructured":"4 Kovarik, J. J., Doshi, P. N., Collinge, J. E. & Plager, D. A. Outcome of pediatric patients referred for papilledema. J. AAPOS. 19, 344\u2013348. https:\/\/doi.org\/10.1016\/j.jaapos.2015.05.007 (2015).","journal-title":"J. AAPOS"},{"key":"55133_CR5","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1212\/WNL.0000000000002318","volume":"86","author":"A 5 Fisayo","year":"2016","unstructured":"5 Fisayo, A., Bruce, B. B., Newman, N. J. & Biousse, V. Overdiagnosis of idiopathic intracranial hypertension. Neurology 86, 341\u2013350. https:\/\/doi.org\/10.1212\/WNL.0000000000002318 (2016).","journal-title":"Neurology"},{"key":"55133_CR6","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1038\/eye.2017.274","volume":"32","author":"A 6 Poostchi","year":"2018","unstructured":"6 Poostchi, A., Awad, M., Wilde, C., Dineen, R. A. & Gruener, A. M. Spike in neuroimaging requests following the conviction of the optometrist Honey Rose. Eye (Lond). 32, 489\u2013490. https:\/\/doi.org\/10.1038\/eye.2017.274 (2018).","journal-title":"Eye (Lond)"},{"key":"55133_CR7","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1097\/WNO.0000000000000846","volume":"40","author":"L 7 Stunkel","year":"2020","unstructured":"7 Stunkel, L., Mackay, D. D., Bruce, B. B., Newman, N. J. & Biousse, V. Referral Patterns in Neuro-Ophthalmology. J. Neuroophthalmol. 40, 485\u2013493. https:\/\/doi.org\/10.1097\/WNO.0000000000000846 (2020).","journal-title":"J. Neuroophthalmol"},{"key":"55133_CR8","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1097\/WNO.0000000000002120","volume":"44","author":"HJ 8 Ray","year":"2024","unstructured":"8 Ray, H. J. et al. The Increasing Burden of Emergency Department and Inpatient Consultations for Papilledema. J. Neuroophthalmol. 44, 571\u2013577. https:\/\/doi.org\/10.1097\/WNO.0000000000002120 (2024).","journal-title":"J. Neuroophthalmol"},{"key":"55133_CR9","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1007\/s10792-025-03603-5","volume":"45","author":"SC 9 Hayat","year":"2025","unstructured":"9 Hayat, S. C., Yilmaz, Y. C., Davulcu, K. & Ozal, S. A. Rising consultations for suspected papilledema: clinical and neuro-ophthalmologic insights. Int. Ophthalmol. 45, 229. https:\/\/doi.org\/10.1007\/s10792-025-03603-5 (2025).","journal-title":"Int. Ophthalmol."},{"key":"55133_CR10","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1001\/jamainternmed.2025.0505","volume":"185","author":"10","year":"2025","unstructured":"10 et al. Projected Lifetime Cancer Risks From Current Computed Tomography Imaging. JAMA Intern. Med. 185, 710\u2013719. https:\/\/doi.org\/10.1001\/jamainternmed.2025.0505 (2025).","journal-title":"JAMA Intern. Med."},{"key":"55133_CR11","doi-asserted-by":"publisher","unstructured":"Bidot, S. et al. 11 Brain Imaging in Idiopathic Intracranial Hypertension. J Neuroophthalmol 35, 400\u2013411 (2015). https:\/\/doi.org\/10.1097\/WNO.0000000000000303","DOI":"10.1097\/WNO.0000000000000303"},{"key":"55133_CR12","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.1016\/S1474-4422(22)00173-9","volume":"21","author":"V 12 Biousse","year":"2022","unstructured":"12 Biousse, V., Danesh-Meyer, H. V., Saindane, A. M., Lamirel, C. & Newman, N. J. Imaging of the optic nerve: technological advances and future prospects. Lancet Neurol. 21, 1135\u20131150. https:\/\/doi.org\/10.1016\/S1474-4422(22)00173-9 (2022).","journal-title":"Lancet Neurol."},{"key":"55133_CR13","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1212\/WNL.0b013e3182a55f17","volume":"81","author":"DI 13 Friedman","year":"2013","unstructured":"13 Friedman, D. I., Liu, G. T. & Digre, K. B. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 81, 1159\u20131165. https:\/\/doi.org\/10.1212\/WNL.0b013e3182a55f17 (2013).","journal-title":"Neurology"},{"key":"55133_CR14","doi-asserted-by":"publisher","unstructured":"14 Crum, O. M. et al. Etiology of Papilledema in Patients in the Eye Clinic Setting. JAMA Netw Open 3, e206625 (2020). https:\/\/doi.org\/10.1001\/jamanetworkopen.2020.6625","DOI":"10.1001\/jamanetworkopen.2020.6625"},{"key":"55133_CR15","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1590\/0100-3984.2021.0091-en","volume":"55","author":"LB 15 Savastano","year":"2022","unstructured":"15 Savastano, L. B. et al. Idiopathic intracranial hypertension: an illustrated guide for the trainee radiologist. Radiol. Bras. 55, 312\u2013316. https:\/\/doi.org\/10.1590\/0100-3984.2021.0091-en (2022).","journal-title":"Radiol. Bras."},{"key":"55133_CR16","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-026-12366-1","author":"T 16 Knoche","year":"2026","unstructured":"16 Knoche, T., Guelsoy, N., Siebert, E., Hollinski, R. & Danyel, L. A. MRI features in atypical idiopathic intracranial hypertension. Eur. Radiol. https:\/\/doi.org\/10.1007\/s00330-026-12366-1 (2026).","journal-title":"Eur. Radiol."},{"key":"55133_CR17","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1001\/jamaneurol.2021.0710","volume":"78","author":"BS 17 Chen","year":"2021","unstructured":"17 Chen, B. S. et al. Prevalence of Incidentally Detected Signs of Intracranial Hypertension on Magnetic Resonance Imaging and Their Association With Papilledema. JAMA Neurol. 78, 718\u2013725. https:\/\/doi.org\/10.1001\/jamaneurol.2021.0710 (2021).","journal-title":"JAMA Neurol."},{"key":"55133_CR18","doi-asserted-by":"publisher","unstructured":"18 Clausen, K., Davis, S. & Pourmand, A. Approach to anisocoria in the emergency department. Am J Emerg Med 69, 218 e211\u2013218 e213 (2023). https:\/\/doi.org\/10.1016\/j.ajem.2023.04.047","DOI":"10.1016\/j.ajem.2023.04.047"},{"key":"55133_CR19","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1111\/j.1553-2712.2008.00192.x","volume":"15","author":"AA 19 Ginde","year":"2008","unstructured":"19 Ginde, A. A., Foianini, A., Renner, D. M., Valley, M. & Camargo, C. A. Jr. Availability and quality of computed tomography and magnetic resonance imaging equipment in U.S. emergency departments. Acad. Emerg. Med. 15, 780\u2013783. https:\/\/doi.org\/10.1111\/j.1553-2712.2008.00192.x (2008).","journal-title":"Acad. Emerg. Med."},{"key":"55133_CR20","doi-asserted-by":"publisher","first-page":"112528","DOI":"10.1016\/j.ejrad.2025.112528","volume":"194","author":"A 20 Platon","year":"2026","unstructured":"20 Platon, A. et al. Emergency Radiology: Organizational Models in Swiss and Nordic Hospitals. Eur. J. Radiol. 194, 112528. https:\/\/doi.org\/10.1016\/j.ejrad.2025.112528 (2026).","journal-title":"Eur. J. Radiol."},{"key":"55133_CR21","doi-asserted-by":"publisher","first-page":"2994","DOI":"10.1007\/s00330-020-07436-x","volume":"31","author":"M 21 Scaglione","year":"2021","unstructured":"21 Scaglione, M. et al. The practice of emergency radiology throughout Europe: a survey from the European Society of Emergency Radiology on volume, staffing, equipment, and scheduling. Eur. Radiol. 31, 2994\u20133001. https:\/\/doi.org\/10.1007\/s00330-020-07436-x (2021).","journal-title":"Eur. Radiol."},{"key":"55133_CR22","doi-asserted-by":"publisher","first-page":"e5022","DOI":"10.1002\/nbm.5022","volume":"36","author":"M 22 Jalloul","year":"2023","unstructured":"22 Jalloul, M. et al. MRI scarcity in low- and middle-income countries. NMR Biomed. 36, e5022. https:\/\/doi.org\/10.1002\/nbm.5022 (2023).","journal-title":"NMR Biomed."},{"key":"55133_CR23","doi-asserted-by":"publisher","first-page":"e77","DOI":"10.1161\/STR.0000000000000456","volume":"55","author":"G 23 Saposnik","year":"2024","unstructured":"23 Saposnik, G. et al. Diagnosis and Management of Cerebral Venous Thrombosis: A Scientific Statement From the American Heart Association. Stroke 55, e77\u2013e90. https:\/\/doi.org\/10.1161\/STR.0000000000000456 (2024).","journal-title":"Stroke"},{"key":"55133_CR24","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.ophtha.2022.09.017","volume":"130","author":"B 24 Tao","year":"2023","unstructured":"24 Tao, B., Vosoughi, A., Margolin, E. & Micieli, J. A. Inappropriate Use of the Term Papilledema in the Medical Literature: A Systematic Review of Case Reports across Specialties. Ophthalmology 130, 129\u2013136. https:\/\/doi.org\/10.1016\/j.ophtha.2022.09.017 (2023).","journal-title":"Ophthalmology"},{"key":"55133_CR25","doi-asserted-by":"publisher","first-page":"608","DOI":"10.2214\/AJR.13.10874","volume":"202","author":"OY 25 Bialer","year":"2014","unstructured":"25 Bialer, O. Y. et al. Meningoceles in idiopathic intracranial hypertension. AJR Am. J. Roentgenol. 202, 608\u2013613. https:\/\/doi.org\/10.2214\/AJR.13.10874 (2014).","journal-title":"AJR Am. J. Roentgenol."},{"key":"55133_CR26","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","volume":"61","author":"26","year":"2008","unstructured":"26 et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J. Clin. Epidemiol. 61, 344\u2013349. https:\/\/doi.org\/10.1016\/j.jclinepi.2007.11.008 (2008).","journal-title":"J. Clin. Epidemiol."},{"key":"55133_CR27","doi-asserted-by":"publisher","unstructured":"27 Beier, D. et al. Magnetic Resonance Imaging Signs of Idiopathic Intracranial Hypertension. JAMA Netw Open 7, e2420138 (2024). https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.20138","DOI":"10.1001\/jamanetworkopen.2024.20138"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-55133-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-55133-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-55133-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T23:21:34Z","timestamp":1779837694000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-55133-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,27]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["55133"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-55133-4","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,27]]},"assertion":[{"value":"18 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16372"}}