Neonatal Nurse Practitioner Practice Exam

What condition is indicated by a term neonate presenting with unequal pupils, slow light response, and tense fontanelles?

1. Intracerebellar hemorrhage

2. Subarachnoid hemorrhage

3. Subdural hemorrhage

4. Hydrocephalus

The correct answer is: Subdural hemorrhage

The condition indicated by a term neonate presenting with unequal pupils, slow light response, and tense fontanelles is indeed hydrocephalus. Hydrocephalus refers to an abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles of the brain, leading to increased intracranial pressure. This excessive pressure can result in abnormal head growth and the expansion of the fontanelles, which may appear tense or bulging. The signs of unequal pupils and a slow light response suggest potential neurological dysfunction, which can occur in cases of increased intracranial pressure affecting the optic nerve pathways. In hydrocephalus, the buildup of CSF can compress surrounding brain structures and impair their function, producing such signs. By understanding these clinical manifestations, it's crucial to differentiate hydrocephalus from other types of hemorrhage such as subdural or subarachnoid hemorrhages, which typically present with different symptoms and would not primarily lead to the same combination of signs observed in this scenario.