Neuroanatomy: meningeal haemorrhage: 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: meningeal haemorrhage

Sample item

A 75-year-old alcoholic man fell three weeks ago and now has drowsiness and confusion. CT shows a crescent-shaped hypodense collection across the right hemisphere. Which vessels are most likely torn?

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

The answer and the reasoning

C. Cerebral bridging veins draining into the superior sagittal sinus

Chronic subdural haematoma follows tearing of the thin-walled bridging veins that cross the subdural space to the dural venous sinuses, particularly in the elderly and alcoholics with cerebral atrophy. The collection is crescentic and crosses suture lines. Middle meningeal arterial bleeding produces a biconvex epidural haematoma with a lucid interval.

Option by option

  • A. Berry aneurysm of the circle of Willis

    A ruptured berry aneurysm causes subarachnoid haemorrhage with blood in the basal cisterns.

  • B. Middle meningeal artery

    The middle meningeal artery is torn in epidural haematoma, which is biconvex and does not cross sutures.

  • C. Cerebral bridging veins draining into the superior sagittal sinus (correct)

    Bridging veins cross the subdural space and are stretched by brain atrophy, giving slow subdural bleeding.

  • D. Lenticulostriate arteries

    Lenticulostriate arteries cause deep intracerebral haemorrhage and not an extra-axial crescent.

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.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, Cerebral bridging veins draining into the superior sagittal sinus. Chronic subdural haematoma follows tearing of the thin-walled bridging veins that cross the subdural space to the dural venous sinuses, particularly in the elderly and alcoholics with cerebral atrophy.

Why is "Berry aneurysm of the circle of Willis" not the answer?

A ruptured berry aneurysm causes subarachnoid haemorrhage with blood in the basal cisterns.

Why is "Middle meningeal artery" not the answer?

The middle meningeal artery is torn in epidural haematoma, which is biconvex and does not cross sutures.

Why is "Lenticulostriate arteries" not the answer?

Lenticulostriate arteries cause deep intracerebral haemorrhage and not an extra-axial crescent.

What concept does this question test?

It tests Neuroanatomy: meningeal haemorrhage in Anatomy. The collection is crescentic and crosses suture lines. Middle meningeal arterial bleeding produces a biconvex epidural haematoma with a lucid interval.

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: meningeal haemorrhage?

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.