After a concussion, which is the earliest sign of increased intracranial pressure?

After a concussion, which is the earliest sign of increased intracranial pressure?

• A. Diplopia
• B. Decreased LOC is the earliest sign
• C. Headache
• D. Pupillary signs

Answer: (B)

The earliest sign is a change in level of consciousness. When intracranial pressure rises after a concussion, brain perfusion drops and global brain function is affected, so the patient becomes more drowsy, confused, or difficult to arouse before focal signs appear. Headache, diplopia, and pupillary abnormalities can occur as pressure increases, but they tend to appear later or are less specific. Pupillary changes and other brainstem signs indicate more advanced involvement, while headaches are common but not the first indicator.

The earliest sign is a change in level of consciousness. When intracranial pressure rises after a concussion, brain perfusion drops and global brain function is affected, so the patient becomes more drowsy, confused, or difficult to arouse before focal signs appear. Headache, diplopia, and pupillary abnormalities can occur as pressure increases, but they tend to appear later or are less specific. Pupillary changes and other brainstem signs indicate more advanced involvement, while headaches are common but not the first indicator.