Which fontanel finding would be most concerning for increased intracranial pressure in an infant?

Which fontanel finding would be most concerning for increased intracranial pressure in an infant?

• A. Bulging and tense fontanel
• B. Soft and flat fontanel
• C. Depressed fontanel
• D. No fontanel present

Answer: (A)

Infants’ fontanelles reflect pressures inside the skull because the skull bones aren’t fully fused yet. When intracranial pressure rises, the anterior fontanelle bulges outward and feels tense as the pressure pushes against the soft spot. That bulging, tense fontanel is the clearest sign of increased ICP in an infant. A soft and flat fontanel usually indicates normal or stable pressure, not elevated. A depressed fontanel points toward dehydration or low circulating volume rather than high pressure. No fontanel present can occur as fontanels naturally close with age and isn’t by itself a sign of increased intracranial pressure.

Infants’ fontanelles reflect pressures inside the skull because the skull bones aren’t fully fused yet. When intracranial pressure rises, the anterior fontanelle bulges outward and feels tense as the pressure pushes against the soft spot. That bulging, tense fontanel is the clearest sign of increased ICP in an infant.

A soft and flat fontanel usually indicates normal or stable pressure, not elevated. A depressed fontanel points toward dehydration or low circulating volume rather than high pressure. No fontanel present can occur as fontanels naturally close with age and isn’t by itself a sign of increased intracranial pressure.