This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Trauma, Subject name: Surgery
The earliest manifestation of increase intracranial pressure following head injury is 
Select and explain. 
A. Hemiparesis, B. Altered mental status, C. Ipsilateral pupillary dilatation, D. Contralateral pupillary dilatation
B: Altered mental status
Answer: B: Altered mental status 
Explanation: Early signs of elevated ICP includes drowsiness and a diminished level of consciousness Coma and unilateral papillary changes are late signs and require immediate intervention Ref : Harrison's 19th edition Pgno :1779