From APLS manual 6E
- Abnormal oculocephalic reflexes (avoid in patients with neck injuries):
When the head is turned to the left or right a normal response is for the eyes to move away from the head movement; an abnormal response is no (or random) movement. See video for a demo of normal reflexes. - Abnormal Posture:
Decorticate (flexed arms, extended legs)
Decerebrate (extended arms, extended legs)
Posturing may need to be elicited by a painful stimulus - Abnormal pupillary responses: unilateral or bilateral dilatation suggests raised ICP
- Abnormal breathing patterns: There are several recognisable breathing pattern abnormalities in raised ICP. However they are often changeable and may vary from hyperventilation to Cheyne-Stokes breathing to apnoea
- Cushing’s Triad: Hypertension, Bradycardia and breathing pattern abnormalities are a late sign of raised ICP