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Raised intracranial pressure — MCCQE Part 1 MCQ

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HardHeadacheRaised intracranial pressureMCCQE Part 1

A 15-year-old boy has 4 weeks of fatigue, headaches, and morning vomiting. Examination shows papilloedema and mild right abducens palsy. BP is normal and there is no fever. What is the most appropriate investigation?

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Correct answer: A — Urgent MRI brain with neuroimaging before lumbar puncture

Papilloedema with morning vomiting and sixth nerve palsy suggests raised intracranial pressure; urgent neuroimaging is required before lumbar puncture. Immediate LP risks herniation if a mass lesion is present. Migraine does not cause papilloedema. Sinus radiography and monospot testing do not address the neurologic red flags.

Reference: CPS headache red flags guidance