Which of the following is an absolute contraindication for PRM?

• A. Acute intracranial bleed
• B. Cranial neuropathy
• C. Traumatic brain injuries
• D. Post Concussive syndrome

Answer: (A)

The main idea here is safety in cranial techniques that use the primary respiratory mechanism. These approaches rely on very subtle intracranial dynamics, so any condition that could worsen brain pressure or bleeding makes the maneuver unsafe. An acute intracranial bleed is an absolute contraindication because even light cranial contact could alter intracranial pressure, potentially worsen the bleed, expand the hemorrhage, or increase the risk of brain herniation.

Traumatic brain injuries and post-concussive syndrome require careful evaluation and stabilization first; they are not absolute contraindications, though caution and imaging clearance are essential. Cranial neuropathy by itself does not automatically preclude PRM, but the underlying cause and stability would guide safety.