Which trio of signs is commonly associated with increased intracranial pressure?

• A. Nausea and vomiting only
• B. Decreased pupillary reactivity alone
• C. Headache, vomiting, and decreased pupillary reactivity or motor changes
• D. Gradual onset of memory loss

Answer: (C)

Increased intracranial pressure presents with signs that reflect pressure on brain structures and pathways. Headache comes from stretching of pain-sensitive meninges and intracranial vessels. Vomiting often results from stimulation of the brain’s vomiting center due to raised pressure. Changes in pupillary reactivity or motor function arise because pressure can compress the oculomotor nerve and disrupt motor pathways, leading to pupils that are less reactive and to motor changes. This combination—headache, vomiting, and altered pupillary reactivity or motor function—best captures the typical presentation of elevated ICP.

Nausea and vomiting alone don’t show the broader brainstem or motor involvement; decreased pupillary reactivity alone misses the accompanying symptoms; and gradual memory loss isn’t an acute ICP sign, making it less consistent with raised intracranial pressure.