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학습 자료 둘러보기 →In infants with open sutures, the skull can expand to compensate for rising intracranial pressure (ICP). The most specific and late sign of decompensation is a tense, bulging anterior fontanelle.
For an accurate assessment, the infant must be upright and quiet. Crying or lying supine can transiently increase venous pressure and cause a false-positive bulge. A normal fontanelle should feel flat or slightly concave in this position.
A bulging fontanelle is a late sign of elevated ICP. Other signs like vomiting, irritability, and a high-pitched cry are nonspecific and can be absent or misleading. Serial head circumference measurement is critical for early detection of progressive hydrocephalus.
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