skip to main content

Raised Intracranial Pressure — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

ModerateNeurology & DevelopmentRaised Intracranial PressureRACP Paediatrics

A 10-year-old boy presents with a 3-month history of worsening headaches, worse in the morning and aggravated by coughing. He has had two episodes of vomiting on waking. Examination shows bilateral papilloedema. What is the most concerning feature suggesting raised intracranial pressure?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Headache relieved by vomiting

Morning headache with vomiting that relieves the headache, combined with papilloedema, strongly suggests raised intracranial pressure. Vomiting that temporarily reduces ICP (and thus reduces headache) is an important red flag. Urgent neuroimaging (MRI or CT) is indicated. Morning headache without papilloedema is less specific. Headache worse at the end of the day is more consistent with tension-type headache.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Headache