Which of the following is a sign of increased ICP in infants?

• A. Low-pitched cry
• B. Sunken fontanel
• C. Distended scalp veins
• D. Increased blood pressure

Answer: (C)

In infants, signs of increased intracranial pressure reflect how the brain and skull respond when pressure within the cranium rises while the fontanels are still open. Distended scalp veins arise because the elevated intracranial pressure impedes venous outflow from the head, causing veins on the scalp to become visibly enlarged. The fontanelle itself tends to be tense or bulging with ICP, not sunken—that sunken fontanel is more typical of dehydration. A low-pitched cry doesn’t fit ICP well; infants with increased pressure often have irritability or a high-pitched cry. While higher systolic blood pressure can occur as part of a compensatory response, it’s a less specific sign in infants than visible scalp vein distension. So distended scalp veins are a clear, age-appropriate indicator of increased ICP in infants.