Neuroimaging: growing skull fracture: 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: growing skull fracture

Sample item

A child has a progressively enlarging scalp swelling three months after a linear parietal skull fracture, and radiographs show widening of the fracture edges. What is the diagnosis?

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

The answer and the reasoning

A. Growing skull fracture with a leptomeningeal cyst

A dural tear beneath a fracture allows brain and CSF to pulsate into the defect, widening the edges and forming a leptomeningeal cyst. It occurs in young children after a linear fracture. Haematoma resolves, osteomyelitis gives a fever and bone destruction, and epidermoids are congenital.

Option by option

  • A. Growing skull fracture with a leptomeningeal cyst (correct)

    Correct. Progressive widening with CSF pulsation indicates a growing fracture.

  • B. Chronic osteomyelitis of the skull

    Osteomyelitis causes fever, tenderness and moth-eaten bone destruction.

  • C. Subgaleal haematoma

    A subgaleal haematoma resolves over weeks and does not widen the fracture.

  • D. Epidermoid cyst of the skull

    An epidermoid is a congenital lytic lesion that is not related to trauma.

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, Growing skull fracture with a leptomeningeal cyst. A dural tear beneath a fracture allows brain and CSF to pulsate into the defect, widening the edges and forming a leptomeningeal cyst.

Why is "Chronic osteomyelitis of the skull" not the answer?

Osteomyelitis causes fever, tenderness and moth-eaten bone destruction.

Why is "Subgaleal haematoma" not the answer?

A subgaleal haematoma resolves over weeks and does not widen the fracture.

Why is "Epidermoid cyst of the skull" not the answer?

An epidermoid is a congenital lytic lesion that is not related to trauma.

What concept does this question test?

It tests Neuroimaging: growing skull fracture in Radiology. It occurs in young children after a linear fracture. Haematoma resolves, osteomyelitis gives a fever and bone destruction, and epidermoids are congenital.

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 Neuroimaging: growing skull fracture?

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.