Which findings indicate increased intracranial pressure?

• A. Change in LOC
• B. Cushing's triad
• C. Pupillary changes
• D. All of the above

Answer: (D)

Rising intracranial pressure affects brain function and perfusion in several ways, so you see a range of signs. A change in level of consciousness happens early because global brain function becomes impaired as perfusion decreases. Pupillary changes occur as the oculomotor nerve and brainstem are affected by pressure, leading to unequal or nonreactive pupils and indicating potential herniation if it progresses. Cushing’s triad—hypertension with a widened pulse pressure, bradycardia, and irregular respiration—is a late but critical pattern that signals brainstem distress from severe ICP. Because each of these findings can accompany elevated intracranial pressure, all of the above are signs that ICP is increased.