<prompt> Which of the following is the earliest bony sign of increased intracranial tension?Erosion of dorsum sellaPineal displacementWidening of sellaCopper beaten appearance  <response>: In general, symptoms and signs that suggest a rise in ICP including headache, vomiting without nausea, ocular palsies, altered level of consciousness, back pain and papilledema. If papilledema is protracted, it may lead to visual disturbances, optic atrophy, and eventually blindness. If mass effect is present with resulting displacement of brain tissue, additional signs may include pupillary dilatation, abducens palsy, and the Cushings triad are also seen. Bony signs of chronic elevated intracranial pressure ICP are 1 diffuse beaten copper pattern 2 dorsum sellae erosion earliest sign 3 suture diastasis and 4 abnormalities of venous drainage that paicularly affect the sigmoid-jugular sinus complex. 