Neuroimaging: spot sign: practice question

A Radiology 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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Radiology · Neuroimaging: spot sign

Sample item

A hypertensive patient has a 25 mL putaminal haemorrhage on CT. CT angiography shows a punctate focus of contrast within the haematoma. What does this finding predict?

AA cerebral abscessBAn underlying saccular aneurysm onlyCA venous infarctDOngoing bleeding and haematoma expansion

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

The answer and the reasoning

D. Ongoing bleeding and haematoma expansion

A spot of contrast inside an acute intracerebral haemorrhage on CT angiography marks active extravasation and predicts haematoma growth, worse outcome and a need for closer monitoring and blood pressure control. It is not a sign of aneurysm, infection or infarct. Early growth is the main target of acute treatment.

Option by option

A. A cerebral abscess
An abscess shows a ring-enhancing lesion with diffusion restriction.
B. An underlying saccular aneurysm only
An aneurysm shows as a vessel outpouching outside the haematoma.
C. A venous infarct
A venous infarct is a haemorrhagic area linked to venous occlusion.
D. Ongoing bleeding and haematoma expansion (correct)
Correct. Contrast inside the haematoma shows active bleeding that predicts expansion.

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 Radiology question

What is the answer to this Radiology question?

The best answer is D, Ongoing bleeding and haematoma expansion. A spot of contrast inside an acute intracerebral haemorrhage on CT angiography marks active extravasation and predicts haematoma growth, worse outcome and a need for closer monitoring and blood pressure control.

Why is "A cerebral abscess" not the answer?

An abscess shows a ring-enhancing lesion with diffusion restriction.

Why is "An underlying saccular aneurysm only" not the answer?

An aneurysm shows as a vessel outpouching outside the haematoma.

Why is "A venous infarct" not the answer?

A venous infarct is a haemorrhagic area linked to venous occlusion.

What concept does this question test?

It tests Neuroimaging: spot sign in Radiology. It is not a sign of aneurysm, infection or infarct. Early growth is the main target of acute treatment.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Neuroimaging: spot sign?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.