When assessing for potential head injuries, which sign would most likely indicate increased intracranial pressure?

Projective vomiting is a significant indicator of increased intracranial pressure (ICP). This form of vomiting is characterized by its forceful ejection, which often occurs without nausea and typically happens after a sudden increase in pressure in the cranial cavity. It can occur in a variety of conditions related to elevated ICP, such as traumatic brain injury, brain tumors, or infections like meningitis. This symptom arises due to the irritation of the vomiting center in the brain as a response to the increased pressure surrounding structures in the cranial cavity.

While confusion, severe headache, and unresponsiveness can also be associated with increased ICP, projective vomiting is particularly telling as it often presents once significant pressure puts stress on the medulla oblongata and other brain centers responsible for coordinating these reflexes. Due to its specific nature, projective vomiting serves as a key sign that alerts healthcare providers to the possibility of serious neurological compromise requiring swift intervention.