Which of the following is the earliest bony sign of increased intracranial tension?
In general, symptoms and signs that suggest a rise in ICP including headache, vomiting without nausea, ocular palsies, altered level of consciousness, back pain and papilledema. If papilledema is protracted, it may lead to visual disturbances, optic atrophy, and eventually blindness. If mass effect is present with resulting displacement of brain tissue, additional signs may include pupillary dilatation, abducens palsy, and the Cushing's triad are also seen. Bony signs of chronic elevated intracranial pressure (ICP) are (1) diffuse beaten copper pattern (2) dorsum sellae erosion (earliest sign) (3) suture diastasis and (4) abnormalities of venous drainage that paicularly affect the sigmoid-jugular sinus complex.
Erosion of dorsum sella
Pineal displacement
Widening of sella
Copper beaten appearance