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Raised intracranial pressure — RACP Paediatrics MCQ

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ModerateGIRaised intracranial pressureRACP Paediatrics

An 8-year-old presents with early morning vomiting and worsening headaches over 4 weeks. The headaches wake him from sleep. On examination there is papilloedema and a left CN VI palsy. What is the most likely cause of the vomiting?

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Correct answer: A — Raised intracranial pressure

Early morning vomiting with progressive headaches that wake from sleep, papilloedema, and a false-localising CN VI palsy (due to raised ICP rather than a direct brainstem lesion) indicate raised intracranial pressure. Urgent neuroimaging (CT/MRI) is required to exclude a posterior fossa tumour.

Reference: RCH Melbourne – 2023 – Headache CPG; RACP Paediatric Curriculum – Neurology