The earliest manifestation of increased intracranial pressure following head injury is:: (A) Ipsilateral pupillary dilatation, (B) Contralateral pupillary dilatation, (C) Altered mental status, (D) Hemiparesis
Answer is C. Early signs of elevated iCP include drowsiness and a diminished level of consciousness (altered mental status). Coma and unilateral papillary changes are late signs and require immediate intervention. Ref: Harrison's Internal Medicine, 16th Edition, Page 1633; Clinical Hepatology: Principles and Practice of Hepatobiliary Diseases By Henryk Dancygier, Scott L. (FRW) Friedman, H. D. (CON) Allescher, U. (CON) Beuers, Volume 2, 2010, Page 938