Trauma: extradural haematoma: practice question

A General Surgery 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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General Surgery · Trauma: extradural haematoma

Sample item

A 19-year-old cricketer struck on the temple by a ball loses consciousness briefly, recovers and talks normally, then becomes drowsy 3 hours later with a dilated right pupil. CT shows a biconvex hyperdense lesion. What is the usual source of bleeding?

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

The answer and the reasoning

C. Middle meningeal artery

A fracture of the thin temporal squama tears the middle meningeal artery, producing an extradural haematoma that is lens-shaped on CT because the dura is adherent at suture lines. The classic lucid interval is followed by rapid deterioration and uncal herniation. Urgent craniotomy and evacuation gives an excellent outcome if done early.

Option by option

  • A. Lenticulostriate arteries

    Lenticulostriate arterial rupture causes hypertensive basal ganglia haemorrhage.

  • B. Bridging cortical veins

    Bridging veins bleed into the subdural space, giving a crescentic collection.

  • C. Middle meningeal artery (correct)

    Correct. Arterial bleeding from the middle meningeal artery explains the lens shape and rapid course.

  • D. Anterior communicating artery

    Anterior communicating aneurysm rupture causes subarachnoid haemorrhage.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Middle meningeal artery. A fracture of the thin temporal squama tears the middle meningeal artery, producing an extradural haematoma that is lens-shaped on CT because the dura is adherent at suture lines.

Why is "Lenticulostriate arteries" not the answer?

Lenticulostriate arterial rupture causes hypertensive basal ganglia haemorrhage.

Why is "Bridging cortical veins" not the answer?

Bridging veins bleed into the subdural space, giving a crescentic collection.

Why is "Anterior communicating artery" not the answer?

Anterior communicating aneurysm rupture causes subarachnoid haemorrhage.

What concept does this question test?

It tests Trauma: extradural haematoma in General Surgery. The classic lucid interval is followed by rapid deterioration and uncal herniation. Urgent craniotomy and evacuation gives an excellent outcome if done early.

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 Trauma: extradural haematoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.