Which finding in an infant with meningitis most strongly indicates increased intracranial pressure?

Which finding in an infant with meningitis most strongly indicates increased intracranial pressure?

• A. Irritability
• B. Headache
• C. Mood swings
• D. Bulging fontanelle

Answer: (D)

Bulging fontanelle signals increased intracranial pressure in an infant. The fontanelle is the soft spot where the skull bones haven’t yet fused, so it acts like a pressure gauge. When ICP rises from meningitis—due to inflammation, swelling, or excess CSF—the pressure pushes outward on the fontanelle, making it bulge. This is a more specific indicator of intracranial hypertension in infancy than irritability or mood changes, and headaches are hard to assess at this age. So the presence of a bulging fontanelle is the strongest clue of elevated ICP.

Bulging fontanelle signals increased intracranial pressure in an infant. The fontanelle is the soft spot where the skull bones haven’t yet fused, so it acts like a pressure gauge. When ICP rises from meningitis—due to inflammation, swelling, or excess CSF—the pressure pushes outward on the fontanelle, making it bulge. This is a more specific indicator of intracranial hypertension in infancy than irritability or mood changes, and headaches are hard to assess at this age. So the presence of a bulging fontanelle is the strongest clue of elevated ICP.