Organic mental disorders: chronic subdural haematoma: practice question

A Psychiatry 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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Psychiatry · Organic mental disorders: chronic subdural haematoma

Sample item

A 74-year-old man with chronic alcohol use fell two months ago. He now has several weeks of increasing drowsiness, headache and confusion with mild left-sided weakness. What is the most likely cause?

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

The answer and the reasoning

A. Chronic subdural haematoma

Elderly and alcohol-dependent people with brain atrophy have stretched bridging veins and are prone to chronic subdural haematoma after minor head injury, which may present weeks later with fluctuating confusion, headache and focal signs. CT shows a crescentic collection, and evacuation can reverse the deficits.

Option by option

  • A. Chronic subdural haematoma (correct)

    Correct. A subacute course after a fall in an at-risk older drinker fits chronic subdural haematoma.

  • B. Wernicke encephalopathy

    Wernicke encephalopathy features ophthalmoplegia and ataxia and does not cause focal weakness.

  • C. Normal pressure hydrocephalus

    Normal pressure hydrocephalus presents with gait disturbance and incontinence over months.

  • D. Alzheimer disease

    Alzheimer disease progresses over years without headache or focal weakness.

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 Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Chronic subdural haematoma. Elderly and alcohol-dependent people with brain atrophy have stretched bridging veins and are prone to chronic subdural haematoma after minor head injury, which may present weeks later with fluctuating confusion, headache and focal signs.

Why is "Wernicke encephalopathy" not the answer?

Wernicke encephalopathy features ophthalmoplegia and ataxia and does not cause focal weakness.

Why is "Normal pressure hydrocephalus" not the answer?

Normal pressure hydrocephalus presents with gait disturbance and incontinence over months.

Why is "Alzheimer disease" not the answer?

Alzheimer disease progresses over years without headache or focal weakness.

What concept does this question test?

It tests Organic mental disorders: chronic subdural haematoma in Psychiatry. CT shows a crescentic collection, and evacuation can reverse the deficits.

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 Organic mental disorders: chronic subdural haematoma?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.