Perioperative care: spinal epidural 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 · Perioperative care: spinal epidural haematoma

Sample item

A patient on prophylactic anticoagulation has an epidural catheter removed after surgery. Hours later he has severe back pain, progressive leg weakness and urinary retention. What is the best management?

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

The answer and the reasoning

A. Emergency MRI and neurosurgical decompression

This picture suggests an epidural haematoma compressing the cord or cauda equina, a surgical emergency. Outcome depends on decompression within a few hours of the onset of deficit, so MRI and neurosurgical review are urgent. Lumbar puncture risks further bleeding.

Option by option

  • A. Emergency MRI and neurosurgical decompression (correct)

    Correct. Rapid imaging and decompression give the best chance of neurological recovery.

  • B. Oral analgesia and physiotherapy

    Analgesia and physiotherapy do not treat a compressive haematoma.

  • C. Lumbar puncture

    Lumbar puncture in a patient with a coagulopathy and a suspected haematoma could cause more bleeding.

  • D. Observation and repeat examination in 24 hours

    Waiting 24 hours allows irreversible compression of the cord.

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.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Emergency MRI and neurosurgical decompression. This picture suggests an epidural haematoma compressing the cord or cauda equina, a surgical emergency.

Why is "Oral analgesia and physiotherapy" not the answer?

Analgesia and physiotherapy do not treat a compressive haematoma.

Why is "Lumbar puncture" not the answer?

Lumbar puncture in a patient with a coagulopathy and a suspected haematoma could cause more bleeding.

Why is "Observation and repeat examination in 24 hours" not the answer?

Waiting 24 hours allows irreversible compression of the cord.

What concept does this question test?

It tests Perioperative care: spinal epidural haematoma in General Surgery. Outcome depends on decompression within a few hours of the onset of deficit, so MRI and neurosurgical review are urgent. Lumbar puncture risks further bleeding.

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 Perioperative care: spinal epidural 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.