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학습 자료 둘러보기 →To accurately assess the anterior fontanelle, the infant must be calm and positioned upright at a 45-90 degree angle. A bulging fontanelle in a supine or crying infant can be a normal physiological finding.
A tense, bulging fontanelle in a quiet, upright infant is a highly specific and objective sign of sustained increased intracranial pressure (ICP). This finding takes precedence over nonspecific symptoms like vomiting or irritability.
Do not rely solely on head circumference measurement, as it indicates a chronic process. A normal fontanelle does not rule out elevated ICP if the sutures have prematurely closed. Late signs like sunset eyes indicate severe, potentially irreversible pressure.
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