Which of the following is the sign of increased intracranial tension in skull x-ray in an infant?: (A) Separation of the sutures, (B) Tense anterior fontanelle, (C) Macewen's sign, (D) All of the above
Answer is D. In increased intracranial tension (ICT), there is separation of the cranial sutures, wide fontanels and increased head circumference. The Macewen's or crackpot sign indicates raised intracranial pressure after sutures and fontanel have closed. Papilledema is unusual in infant unless the increase in intracranial pressure is very rapid. Ref: Ghai Essential Pediatrics, 6th edition, Page 525.