Intracranial Hemorrhage

Question 1

A 22-year-old male is brought to the ED after a motorcycle accident. On arrival, he is unconscious but regains consciousness. A few hours later, he develops a headache, vomiting, and left pupil dilation. A CT scan shows a biconvex, hyperdense collection not crossing suture lines. Which vessel is most likely injured?

A) Bridging veins
B) Middle meningeal artery
C) Anterior cerebral artery
D) Posterior cerebral artery
E) Superior sagittal sinus

Answer 1

B

Question 2

A 75-year-old chronic alcoholic presents with progressive confusion for 2 weeks. He has a history of multiple falls. A CT scan shows a crescent-shaped, hypodense lesion crossing suture lines. What is the most likely diagnosis?

A) Epidural hematoma
B) Chronic subdural hematoma
C) Acute subdural hematoma
D) Subarachnoid hemorrhage
E) Intraparenchymal hemorrhage

Answer 2

B

Question 3

A 45-year-old woman presents with a sudden severe headache, vomiting, and neck stiffness. A CT scan shows hyperdense material in the basal cisterns. LP reveals xanthochromic CSF. Which medication is used to prevent complications?

A) Mannitol
B) Nimodipine
C) Heparin
D) Alteplase
E) Phenytoin

Answer 3

B

Question 4

A 60-year-old man with long-standing hypertension presents with sudden-onset right-sided weakness and slurred speech. His blood pressure is 200/110 mmHg. A CT scan shows a hyperdense lesion in the left basal ganglia. Which of the following vessels is most likely involved?

A) Middle meningeal artery
B) Lenticulostriate arteries
C) Anterior cerebral artery
D) Posterior cerebral artery
E) Basilar artery

Answer 4

B

Hypertensive Charcot-Bouchard aneurysms rupture in the putamen and basal ganglia, which are supplied by the lenticulostriate arteries.