The Cushing reflex is typically seen with increased intracranial pressure and includes which sign?

The Cushing reflex is typically seen with increased intracranial pressure and includes which sign?

• A. Hypertension with bradycardia.
• B. Tachycardia with hypotension.
• C. Hyperthermia with tachypnea.
• D. Hypotension with tachycardia.

Answer: (A)

When intracranial pressure rises, the brain tries to maintain blood flow to the brain by increasing systemic blood pressure. That pressure rise triggers the baroreceptors to slow the heart, so you get a high blood pressure together with a slower heart rate. This combination—hypertension with bradycardia—is the classic sign of the Cushing reflex, which also often accompanies irregular respirations as ICP climbs. It’s a warning that ICP is increasing and brain perfusion is being compromised, signaling the need for urgent assessment and management. Other patterns, like tachycardia with hypotension or hyperthermia with rapid breathing, fit different problems such as shock or systemic illness and don’t reflect this brain-stem–mediated response.

When intracranial pressure rises, the brain tries to maintain blood flow to the brain by increasing systemic blood pressure. That pressure rise triggers the baroreceptors to slow the heart, so you get a high blood pressure together with a slower heart rate. This combination—hypertension with bradycardia—is the classic sign of the Cushing reflex, which also often accompanies irregular respirations as ICP climbs. It’s a warning that ICP is increasing and brain perfusion is being compromised, signaling the need for urgent assessment and management.

Other patterns, like tachycardia with hypotension or hyperthermia with rapid breathing, fit different problems such as shock or systemic illness and don’t reflect this brain-stem–mediated response.