Question

Which of the following clinical signs is the most worrisome in a patient whom elevation of ICP is a concern?

1) Tachycardia
2) Asymmetric pupils
3) Hypothermia
4) Decreased blood pressure

Answer 1

The most worrisome symptom in a patient with a concern for elevated ICP is asymmetric pupils, which suggest Herniation Syndrome, a potentially fatal condition.

Step-by-step explanation:

Among the clinical signs listed indicating concern for elevated intracranial pressure (ICP), the most worrisome is 2) Asymmetric pupils. Asymmetric pupils, or anisocoria, can signal Herniation Syndrome, which is a life-threatening condition often caused by the increase of pressure within the skull. Conditions like herniation may compress the brainstem or cranial nerves and indicate that the brain is experiencing significant pressure shifts. This may precede neurological decline and require immediate medical intervention. In contrast, tachycardia and decreased blood pressure can have multiple causes and may not be directly indicative of ICP changes. Hypothermia is also concerning but is less specific to elevated ICP compared to anisocoria.