Neuroanatomy: vascular supply and aneurysms: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Neuroanatomy: vascular supply and aneurysms

Sample item

A 45-year-old woman has a sudden thunderclap headache, neck stiffness and blood in the subarachnoid space on CT. Angiography shows a saccular aneurysm. Which site is the most common location for such a ruptured aneurysm?

ABasilar bifurcationBOrigin of the posterior inferior cerebellar arteryCCavernous segment of the internal carotid arteryDJunction of the anterior communicating and anterior cerebral arteries

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Junction of the anterior communicating and anterior cerebral arteries

Berry (saccular) aneurysms arise at arterial bifurcations of the circle of Willis, most often at the junction of the anterior communicating artery with the anterior cerebral artery. Next in frequency are the posterior communicating origin and the middle cerebral artery bifurcation. Rupture causes subarachnoid haemorrhage, and the cavernous carotid is a rare site of rupture.

Option by option

A. Basilar bifurcation
The basilar tip is a recognised site but less common than the anterior communicating junction.
B. Origin of the posterior inferior cerebellar artery
The PICA origin is an uncommon site.
C. Cavernous segment of the internal carotid artery
The cavernous carotid is extradural, so rupture does not typically cause subarachnoid haemorrhage.
D. Junction of the anterior communicating and anterior cerebral arteries (correct)
Correct. The anterior communicating junction is the commonest site.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is D, Junction of the anterior communicating and anterior cerebral arteries. Berry (saccular) aneurysms arise at arterial bifurcations of the circle of Willis, most often at the junction of the anterior communicating artery with the anterior cerebral artery.

Why is "Basilar bifurcation" not the answer?

The basilar tip is a recognised site but less common than the anterior communicating junction.

Why is "Origin of the posterior inferior cerebellar artery" not the answer?

The PICA origin is an uncommon site.

Why is "Cavernous segment of the internal carotid artery" not the answer?

The cavernous carotid is extradural, so rupture does not typically cause subarachnoid haemorrhage.

What concept does this question test?

It tests Neuroanatomy: vascular supply and aneurysms in Anatomy. Next in frequency are the posterior communicating origin and the middle cerebral artery bifurcation. Rupture causes subarachnoid haemorrhage, and the cavernous carotid is a rare site of rupture.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroanatomy: vascular supply and aneurysms?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.