Question 1

Q: A 22-year-old male is brought to the emergency department after a road traffic accident. He had a brief loss of consciousness, followed by a lucid interval of approximately 2 hours, and has now become increasingly drowsy with a GCS of 10. A non-contrast CT of the brain is shown in Image 4. Which of the following vessels is most commonly responsible for this type of intracranial collection?

A. Middle meningeal artery. ***A. Middle meningeal artery*** - The classic clinical presentation of a **lucid interval** followed by rapid neurological decline is pathognomonic for an **extradural (epidural) hematoma** (EDH). - EDHs typically result from a skull fracture at the **pterion**, leading to the rupture of the **middle meningeal artery**, which creates a **biconvex (lentiform)** hyperdense collection on CT. *B. Bridging cortical veins* - Rupture of these vessels results in a **subdural hematoma** (SDH), which typically presents with a more gradual onset of symptoms compared to EDH. - Radiologically, SDH appears as a **crescent-shaped** collection that **crosses suture lines**, unlike the localized lenticular shape of EDH. *C. Superior sagittal sinus* - Injury to the dural venous sinuses typically occurs in the setting of severe depressed skull fractures and causes **venous sinus thrombosis** or large venous hemorrhages. - While it can cause an EDH, it is much less common than arterial rupture and often presents with **venous infarction** or bilateral signs rather than a classic lucid interval. *D. Anterior cerebral artery* - The **anterior cerebral artery** is an intracranial vessel; its rupture typically leads to **subarachnoid hemorrhage** or intracerebral hematoma, not an extradural collection. - Traumatic injury to this vessel is rare compared to the **middle meningeal artery** and would not be associated with the specific convex biconvex CT pattern seen in EDH.

Question

A 22-year-old male is brought to the emergency department after a road traffic accident. He had a brief loss of consciousness, followed by a lucid interval of approximately 2 hours, and has now become increasingly drowsy with a GCS of 10. A non-contrast CT of the brain is shown in Image 4. Which of the following vessels is most commonly responsible for this type of intracranial collection?

Accepted Answer

A. Middle meningeal artery

Answer

B. Bridging cortical veins

Answer

C. Superior sagittal sinus

Answer

D. Anterior cerebral artery

Trauma — MCQs

Trauma — MCQs

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