Tense fontanelle

Palpable, protuberant, bulging fontanelle with increased tension. Most often reflecting elevated intracranial pressure or other intracranial pathology. Possible causes are physiologic (crying, vomiting, coughing, postural), infection (meningitis, encephalitis, brain abscess), hydrocephalus, intracranial hemorrhage, traumatic brain injury, Shaken Baby syndrome, brain tumor, and pseudotumor cerebri (idiopathic intracranial hypertension).