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학습 자료 둘러보기 →In a child with fever and headache, the transition from irritability to lethargy or confusion is a red flag for encephalitis or bacterial meningitis. This signals direct CNS involvement and risk of cerebral edema.
Prioritize a focused neurological exam including Glasgow Coma Scale, pupillary response, and signs of meningismus. Do not delay empirical treatment for a CT scan if signs of herniation are absent.
Do not mistake postictal state or severe dehydration for primary encephalopathy, but treat the most lethal possibility first. Cushing's triad is a late and often preterminal sign of increased ICP.
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