Musculoskeletal, Neurological, Behavioral/PsychosocialDifficulty 3/5
Which set of findings suggests impending herniation in a patient with rising intracranial pressure?
- ACushing’s triad with a newly dilated pupil, indicating brainstem compression
- BHypotension, tachycardia and rapid shallow breathing with equal pupils
- CNormal vital signs with a gradually improving level of consciousness
- DFever, tachycardia and hypotension consistent with an early septic response
Show answer and rationale
Correct: A. Cushing's triad — hypertension with a widening pulse pressure, bradycardia and irregular respirations — combined with a unilateral dilated pupil indicates brainstem compression and demands immediate intervention.
- B — That pattern suggests hypovolaemia or shock rather than herniation.
- C — Improving consciousness is inconsistent with herniation.
- D — Those findings describe sepsis.