Neuroimaging: CT in raised intracranial pressure: 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: CT in raised intracranial pressure

Sample item

A CT head of a patient with a large MCA infarct shows effacement of sulci, midline shift of 8 mm and obliteration of the basal cisterns. What does this signify?

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

The answer and the reasoning

A. Raised intracranial pressure with impending herniation

Midline shift, compression of the ventricles and loss of the basal cisterns reflect mass effect and risk of transtentorial herniation. Decompressive craniectomy may be life-saving in malignant MCA infarction. Atrophy shows widened sulci, not effaced ones.

Option by option

  • A. Raised intracranial pressure with impending herniation (correct)

    Correct. Cisternal effacement and shift indicate dangerous mass effect.

  • B. Normal postoperative state

    These findings are not a normal state.

  • C. Communicating hydrocephalus alone

    Hydrocephalus alone does not cause midline shift.

  • D. Chronic atrophy

    Atrophy shows widened sulci and enlarged ventricles.

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 Radiology question

What is the answer to this Radiology question?

The best answer is A, Raised intracranial pressure with impending herniation. Midline shift, compression of the ventricles and loss of the basal cisterns reflect mass effect and risk of transtentorial herniation.

Why is "Normal postoperative state" not the answer?

These findings are not a normal state.

Why is "Communicating hydrocephalus alone" not the answer?

Hydrocephalus alone does not cause midline shift.

Why is "Chronic atrophy" not the answer?

Atrophy shows widened sulci and enlarged ventricles.

What concept does this question test?

It tests Neuroimaging: CT in raised intracranial pressure in Radiology. Decompressive craniectomy may be life-saving in malignant MCA infarction. Atrophy shows widened sulci, not effaced ones.

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: CT in raised intracranial pressure?

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.