Which symptom would prompt immediate evaluation for possible increased ICP?

• A. Vomiting
• B. Drowsiness worse at night
• C. Normal sleep
• D. No symptoms

Answer: (A)

Rising intracranial pressure commonly presents with vomiting as an early and urgent sign in children. The vomiting center can be irritated by brain pressure, so persistent vomiting without a clear gastrointestinal cause strongly suggests a brain process such as edema, a mass, hydrocephalus, or hemorrhage. This is why vomiting prompts immediate neuro evaluation to prevent deterioration or herniation. Drowsiness worsened at night can be due to many non-ICP factors and is less specific, while normal sleep or no symptoms do not indicate a problem.