What is a primary symptom indicating possible increased intracranial pressure in a child?

Morning vomiting and nocturnal headaches are significant indicators of possible increased intracranial pressure (ICP) in a child. Elevated ICP can lead to a variety of symptoms due to the pressure exerted on the brain. Vomiting, particularly when it occurs in the morning, is often a result of increased pressure on the brain's centers responsible for regulating nausea and vomiting. This symptom tends to happen after the child has been lying down overnight, allowing the pressure to build up as brain swelling can be influenced by positional changes.

Nocturnal headaches are also characteristic, as they may arise from the same increased pressure dynamics, causing discomfort and pain that can wake the child during the night or early morning. These headaches can indicate that the intracranial pressure is notably elevated.

Other symptoms associated with increased ICP may also include changes in vision, irritability, or altered mental status, but morning vomiting and nocturnal headaches specifically highlight the physiological effects of pressure on the brain, making them critical indicators.