Which sign is a late indicator of intracranial hypertension?

Which sign is a late indicator of intracranial hypertension?

• A. Change in LOC.
• B. Papilledema.
• C. Bradycardia.
• D. Nasal drainage halo sign.

Answer: (B)

Intracranial pressure elevations evolve over time, with signs progressing from early brain function changes to later warning signs as the situation worsens. Papilledema, swelling of the optic disc seen on eye exam, develops only after ICP has been elevated for some duration because the optic nerve head becomes edematous as venous drainage is hindered and axoplasmic flow is disrupted. This delay means papilledema is a late indicator of intracranial hypertension. In contrast, changes in level of consciousness can occur earlier as the brain tissue is affected, and a CSF leak (nasal drainage halo) points to a breach rather than to sustained high ICP. Bradycardia can occur with severe ICP as part of the body's secondary response to pressure (the Cushing reflex), but papilledema specifically signals prolonged elevation of ICP and is the hallmark late sign.

Intracranial pressure elevations evolve over time, with signs progressing from early brain function changes to later warning signs as the situation worsens. Papilledema, swelling of the optic disc seen on eye exam, develops only after ICP has been elevated for some duration because the optic nerve head becomes edematous as venous drainage is hindered and axoplasmic flow is disrupted. This delay means papilledema is a late indicator of intracranial hypertension. In contrast, changes in level of consciousness can occur earlier as the brain tissue is affected, and a CSF leak (nasal drainage halo) points to a breach rather than to sustained high ICP. Bradycardia can occur with severe ICP as part of the body's secondary response to pressure (the Cushing reflex), but papilledema specifically signals prolonged elevation of ICP and is the hallmark late sign.