The following are recognized signs and symptoms of raised intracranial tension in a 9-month-old infant, EXCEPT:
**Core Concept**
Raised intracranial tension in infants can manifest differently than in adults, due to the unique anatomy and physiology of the developing brain. In infants, increased intracranial pressure can lead to signs and symptoms that are not immediately apparent, requiring a high index of suspicion for timely diagnosis.
**Why the Correct Answer is Right**
The correct answer is related to the fact that infants have a relatively large head size and a non-rigid skull, which allows for some degree of cranial expansion in response to increased intracranial pressure. However, this does not necessarily mean that infants with raised intracranial tension will exhibit the same classic signs as adults, such as papilledema or altered mental status.
**Why Each Wrong Option is Incorrect**
* **Option A:** This is a recognized sign of raised intracranial tension in infants, as it can lead to increased pressure on the brain and subsequent clinical manifestations.
* **Option B:** This is also a valid symptom of raised intracranial tension in infants, as it can be indicative of increased pressure on the brain and subsequent neurological compromise.
* **Option D:** This is another potential sign of raised intracranial tension in infants, as it can be related to the increased pressure on the brain and subsequent clinical manifestations.
**Clinical Pearl / High-Yield Fact**
In infants, the "bulging fontanelle" is a classic sign of raised intracranial tension, but it is essential to note that this can be a late sign, and timely diagnosis often requires a combination of clinical evaluation and imaging studies.
**Correct Answer: D.**