Which reflex involves increased systolic blood pressure and decreased heart rate in response to elevated intracranial pressure?

• A. Concussion
• B. Subdural hematoma
• C. Brain herniation
• D. Cushing reflex

Answer: (D)

When intracranial pressure rises, the body can mount a protective response to maintain blood flow to the brain. The brain tries to preserve cerebral perfusion pressure by increasing the overall blood pressure while the heart rate slows. This combination—higher systolic blood pressure with a slower pulse—is known as the Cushing reflex. It’s the best answer because it directly describes a reflex pattern that occurs in response to elevated ICP, signaling that the brain is trying to cope with the increased pressure.

Other options describe conditions or outcomes rather than the reflex itself. A concussion is a mild traumatic brain injury, not a reflex to ICP. A subdural hematoma is a source of raised ICP, but it’s a condition that causes the pressure rather than a reflex to it. Brain herniation is a severe result of rising ICP, not the reflex pattern being described. Recognizing the Cushing reflex is important because it indicates significant ICP elevation and the need for urgent management to prevent further brain injury.