Early manifestations of increased intracranial pressure can include which of the following?

• A. Diplopia
• B. Rash
• C. Dizziness
• D. Hyperthermia

Answer: (A)

Elevated intracranial pressure often shows up as neurologic changes from stretching and compression of structures inside the skull. The sixth cranial nerve is particularly sensitive to pressure because it has a long intracranial course, so when ICP rises, this nerve can be affected early. A palsy of CN VI leads to impaired abduction of the affected eye, producing horizontal double vision (diplopia) that is commonly an early sign of rising ICP. The other options don’t fit as typical early indicators: a rash isn’t related to ICP, dizziness is nonspecific and not a hallmark early sign, and hyperthermia isn’t an early feature of intracranial pressure elevation.