ABSTRACT
The assessment is that Cheryl has bilateral papilledema, which is considered an emergency and requires an immediate consultation. Physical examination reveals a wide-awake boy who also has bilateral papilloedema and no other neurological findings. Although vascular disease processes usually produce acute-onset symptoms, bleeding from veins draining the brain may occur over a prolonged period of time in the form of chronic subdural hematoma; again, this is a space-occupying lesion, which might give rise to headache and raised intracranial pressure (ICP). An intraventricular colloid cyst could be considered a space-occupying lesion if it obstructed the outflow of cerebrospinal fluid (CSF) from the lateral ventricles into the third ventricle or from the third ventricle into the aqueduct thereby causing increased ICP. Cheryl was soon back on the road and arrived home safely. Her mother, hearing the story, insisted that she seek immediate medical attention and Cheryl is now in the emergency room (ER) at local community hospital, the morning following the incident.
