🩺 Nursing Question of the Day

Challenge yourself with one exam-style nursing question every day.

✅ Think carefully • ✅ Choose your answer • ✅ Then scroll down to check the explanation.

🧠 Increased Intracranial Pressure & Cushing Triad

✅ Answer: (C) Cushing Triad

📖 What is Cushing Triad?

Cushing = Named after Harvey Cushing, a neurosurgeon who described important signs associated with increased intracranial pressure.
Triad = A group of three characteristic clinical findings.

👉 Cushing triad is a late and concerning sign of significantly increased intracranial pressure and impending brain herniation.

🩺 The Three Components

👉 The combination of these three findings is the classic Cushing triad.

📖 Why Does It Occur?

As intracranial pressure rises, cerebral perfusion can become compromised. The body attempts to maintain blood flow to the brain by increasing arterial pressure.

The increased blood pressure triggers a baroreceptor-mediated slowing of the heart rate. Progressive pressure on the brainstem can then produce irregular respirations.

❌ Why Other Options Are Wrong?

(A) Neurogenic Shock
❌ Usually involves hypotension and bradycardia due to loss of sympathetic vascular tone, often after spinal cord injury.

(B) Spinal Shock
❌ Characterized by temporary loss of motor, sensory, and reflex activity below the level of spinal cord injury. It is not defined by hypertension, bradycardia, and irregular respirations.

(C) Cushing Triad
✅ Correct. The classic triad is hypertension + bradycardia + irregular respirations, particularly in the setting of increased ICP.

(D) Autonomic Dysreflexia
❌ Causes sudden severe hypertension, usually in patients with spinal cord injury above T6, often accompanied by headache, sweating, and flushing above the injury. It is not the classic triad described here.

📝 Quick Comparison

📌 Exam Tip: In a patient with increased intracranial pressure, the sudden appearance of hypertension, bradycardia, and irregular respirations is a serious late warning sign of worsening intracranial pressure and possible brain herniation. It requires immediate intervention.