Which early signs are associated with hydrocephalus in infants?

Choice A rationale Frontal bossing (prominent forehead) is a sign of long-standing, chronic increased intracranial pressure (ICP), as the cranial sutures separate to accommodate the increased volume. In infants, the cranium can enlarge, but frontal bossing is generally a later sign, not an early indicator of acutely rising ICP. Choice B rationale A bulging fontanel is an early and crucial sign reflecting an acute rise in intracranial pressure (ICP) due to excess cerebrospinal fluid accumulation within the ventricles. The fontanel's tenseness indicates pressure transmission, as the open sutures allow expansion, which is a key compensatory mechanism in the infant skull. Choice C rationale Poor feeding is a non-specific but common early sign of increased intracranial pressure (ICP), which affects the brainstem centers controlling appetite and satiety. The pressure can also induce nausea and vomiting due to direct stimulation of the emetic center, contributing to decreased oral intake. Choice D rationale Dilated scalp veins are an early compensatory response to increased intracranial pressure (ICP). The rising pressure impedes venous return from the brain through the dural sinuses, causing a backup that manifests as visibly engorged and dilated veins on the scalp. Choice E rationale Bradycardia is a component of the Cushing's triad (along with widening pulse pressure and irregular respirations), signifying a critical, though sometimes early, response to severe elevation of intracranial pressure (ICP), primarily through stimulation of the vagus nerve.