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Answer

Answer 20-4. The patient with increased intracranial pressure may be awakened from sleep by headache. Papilledema or loss of venous pulsations in fundus of eye may be observed. Cushing response (increase BP with decrease pulse) occurs in a small number of cases.

There may be signs of herniation (there are several types: subfalcine/cingulate, transtentorial, cerebellar). Transtentorial herniation is most common, often resulting in a dilating pupil (usually ipsilateral) and hemipareis (usually contralateral).