The earliest manifestation of increased intracranial pressure following head injury is:
Early signs of elevated iCP include drowsiness and a diminished level of consciousness (altered mental status). Coma and unilateral papillary changes are late signs and require immediate intervention. Ref: Harrison's Internal Medicine, 16th Edition, Page 1633; Clinical Hepatology: Principles and Practice of Hepatobiliary Diseases By Henryk Dancygier, Scott L. (FRW) Friedman, H. D. (CON) Allescher, U. (CON) Beuers, Volume 2, 2010, Page 938
Ipsilateral pupillary dilatation
Contralateral pupillary dilatation
Altered mental status
Hemiparesis