Neuroimaging: subfalcine herniation: 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.

Try it

Radiology · Neuroimaging: subfalcine herniation

Sample item

A patient with a large right frontal mass has midline shift on CT, with the cingulate gyrus pushed beneath the falx. Which vessel is most at risk of compression and infarction?

AAnterior choroidal arteryBPosterior cerebral arteryCMiddle cerebral arteryDAnterior cerebral artery

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

The answer and the reasoning

D. Anterior cerebral artery

In subfalcine herniation the cingulate gyrus slides under the free edge of the falx, pushing the pericallosal branches of the anterior cerebral artery across. Infarction causes contralateral leg weakness.

Option by option

A. Anterior choroidal artery
The anterior choroidal artery runs along the optic tract and is not involved here.
B. Posterior cerebral artery
The PCA is compressed in uncal herniation against the tentorium.
C. Middle cerebral artery
The MCA lies in the Sylvian fissure and is not compressed by subfalcine herniation.
D. Anterior cerebral artery (correct)
Correct. The anterior cerebral artery branches are pinned under the falx.

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, Anterior cerebral artery. In subfalcine herniation the cingulate gyrus slides under the free edge of the falx, pushing the pericallosal branches of the anterior cerebral artery across.

Why is "Anterior choroidal artery" not the answer?

The anterior choroidal artery runs along the optic tract and is not involved here.

Why is "Posterior cerebral artery" not the answer?

The PCA is compressed in uncal herniation against the tentorium.

Why is "Middle cerebral artery" not the answer?

The MCA lies in the Sylvian fissure and is not compressed by subfalcine herniation.

What concept does this question test?

It tests Neuroimaging: subfalcine herniation in Radiology. Infarction causes contralateral leg weakness.

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 Neuroimaging: subfalcine herniation?

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.