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We are concerned there may be a widely held misconception that critically rising intracranial pressure (ICP) is always accompanied by a progressive deterioration in Glasgow Coma Scale (GCS).1 We present two cases when the GCS remained 15, despite critically high ICP.
A 15-year-old girl presented with a 2 month history of headaches and episodic vomiting. Her initial heart rate in the ward was 46 bpm and her blood pressure was 106/71. Her GCS was 15. Examination was unremarkable. Her heart rate fluctuated between 50 and 65. Approximately 7 h after admission, her headache became unbearable and she developed severe neck pain. Her blood pressure …
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