Which finding is not an indication of increased intracranial pressure in an infant?

• A. Irritability
• B. Pulsating anterior fontanel
• C. Altered pupil reactivity
• D. Cheyne-Stokes respirations

Answer: (B)

In infants, signs of increased intracranial pressure are about how the brain and brainstem are being affected, rather than just a skull feature. Irritability, changes in pupil reactivity, and abnormal breathing patterns like Cheyne-Stokes respirations point to brain irritation or pressure affecting autonomic control and brainstem function. These are true indicators that ICP may be elevated.

A pulsating anterior fontanel, by contrast, can be a normal variation or simply a reflection of arterial pulsations through the soft fontanel, especially with crying or fussiness. It does not by itself indicate raised ICP. True ICP elevation would more likely manifest as a bulging or tense fontanel along with other signs, rather than just a noticeable pulsation.