The peaking sign is seen in cross-sectional imaging of the brain and is suggestive of a tension pneumocephalus. It represents the frontal lobes being pushed together forming a peak in the midline giving a heaped up appearance surrounded by air 1. Later, as the frontal lobes become separated they take on the so-called Mount Fuji sign.
Although usually encountered in the setting of tension pneumocephalus it is not pathognomonic of increased pressure.
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