Injuries and wounds: heat extradural haematoma: practice question

A Forensic Medicine 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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Forensic Medicine · Injuries and wounds: heat extradural haematoma

Sample item

A charred body is recovered from a burnt house. Under the skull vault lies a brownish, friable, honeycombed clot above the dura. There is no skull fracture beneath it, no brain contusion and no sign of a blow to the head. What is the most likely explanation?

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

The answer and the reasoning

C. Blood drawn from the diploic veins and sinuses by heat

A heat haematoma forms in a burnt body when heat shrinks the dura and forces blood out of the diploic veins and venous sinuses into the extradural space. It is chocolate-brown, brittle and honeycombed, and is not accompanied by a fracture or contusion. A true traumatic extradural haematoma is a firm, dark red clot with a lens shape over a fracture.

Option by option

  • A. Rupture of the middle meningeal artery by a blow

    A traumatic extradural haematoma follows a blow with a fracture, and the clot is firm and dark red rather than friable.

  • B. Tearing of bridging veins during a fall

    Bridging vein tears produce subdural, not extradural, blood.

  • C. Blood drawn from the diploic veins and sinuses by heat (correct)

    Correct. Heat acting on the skull and dura produces a postmortem extradural clot.

  • D. Postmortem hypostasis within the extradural space

    Hypostasis does not form a friable honeycombed clot in a closed space.

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 Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is C, Blood drawn from the diploic veins and sinuses by heat. A heat haematoma forms in a burnt body when heat shrinks the dura and forces blood out of the diploic veins and venous sinuses into the extradural space.

Why is "Rupture of the middle meningeal artery by a blow" not the answer?

A traumatic extradural haematoma follows a blow with a fracture, and the clot is firm and dark red rather than friable.

Why is "Tearing of bridging veins during a fall" not the answer?

Bridging vein tears produce subdural, not extradural, blood.

Why is "Postmortem hypostasis within the extradural space" not the answer?

Hypostasis does not form a friable honeycombed clot in a closed space.

What concept does this question test?

It tests Injuries and wounds: heat extradural haematoma in Forensic Medicine. It is chocolate-brown, brittle and honeycombed, and is not accompanied by a fracture or contusion. A true traumatic extradural haematoma is a firm, dark red clot with a lens shape over a fracture.

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 Injuries and wounds: heat extradural haematoma?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine 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.