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Raised intracranial pressure — MRCPCH FOP MCQ

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HardNeurology and neurodevelopmentRaised intracranial pressureMRCPCH FOP

A 6-year-old boy has three weeks of early morning vomiting, worsening headaches and new unsteadiness. Examination shows papilloedema and broad-based gait. What is the most appropriate investigation?

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Correct answer: C — Urgent MRI brain with senior paediatric involvement

Progressive morning headache, vomiting, papilloedema and ataxia indicate raised intracranial pressure, requiring urgent neuroimaging. Lumbar puncture before imaging may precipitate herniation. Migraine treatment would be unsafe because the course and examination contain red flags. The pearl is that papilloedema changes the pathway from outpatient headache management to emergency assessment.

Reference: NICE CKS Brain tumours children; RCPCH Progress syllabus