WBR0289: Difference between revisions
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|SubCategory=Neurology | |SubCategory=Neurology | ||
|Prompt=A 38-year-old male presents to the emergency room with complaints of a headache, difficulty maintaining balance, and progressive memory loss. Three weeks prior to presentation, he was involved in a motor vehicle accident. During examination the man appears alert and oriented to his identity, but not to the current location or date. A CT scan of the head demonstrates a crescent-shaped hemorrhage crossing the suture lines. A rupture in which of the following structures is the most likely cause of this patient’s symptoms? | |Prompt=A 38-year-old male presents to the emergency room with complaints of a headache, difficulty maintaining balance, and progressive memory loss. Three weeks prior to presentation, he was involved in a motor vehicle accident. During examination the man appears alert and oriented to his identity, but not to the current location or date. A CT scan of the head demonstrates a crescent-shaped hemorrhage crossing the suture lines. A rupture in which of the following structures is the most likely cause of this patient’s symptoms? | ||
|Explanation=The patient in this scenario presents with symptoms suggestive of [[subdural hematoma]], which occurs as a result of the rupture of the bridging veins. It is | |Explanation=The patient in this scenario presents with symptoms suggestive of [[subdural hematoma]], which occurs as a result of the rupture of the bridging veins. It is often observed in elderly individuals, alcoholics, blunt trauma patients, and individuals suffering from [[shaken baby syndrome]]. A CT scan of the head would demonstrate a crescent-shaped hemorrhage crossing the suture lines. The gyri would be preserved because pressure is equally distributed due to the relatively gradual accumulation of blood. | ||
Educational Objective | Educational Objective | ||
Revision as of 15:48, 2 July 2014
| Author | [[PageAuthor::Ogheneochuko Ajari, MB.BS, MS [1] (Reviewed by Alison Leibowitz)]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pathology |
| Sub Category | SubCategory::Neurology |
| Prompt | [[Prompt::A 38-year-old male presents to the emergency room with complaints of a headache, difficulty maintaining balance, and progressive memory loss. Three weeks prior to presentation, he was involved in a motor vehicle accident. During examination the man appears alert and oriented to his identity, but not to the current location or date. A CT scan of the head demonstrates a crescent-shaped hemorrhage crossing the suture lines. A rupture in which of the following structures is the most likely cause of this patient’s symptoms?]] |
| Answer A | AnswerA::Rupture of the middle meningeal artery |
| Answer A Explanation | [[AnswerAExp::Rupture of the middle meningeal artery occurs with epidural hematoma]] |
| Answer B | AnswerB::Rupture of an aneurysm |
| Answer B Explanation | [[AnswerBExp::Rupture of an aneurysm occurs in subarachnoid hemorrhage, which may occur as a complication of Marfan’s syndrome, Ehlers-Danlos syndrome, adult polycystic kidney disease, or arteriovenous malformation.]] |
| Answer C | AnswerC::Rupture of bridging veins |
| Answer C Explanation | AnswerCExp::See explanation |
| Answer D | AnswerD::Rupture of the anterior communicating artery |
| Answer D Explanation | [[AnswerDExp::Rupture of the anterior communicating artery typically causes visual field defects in patients.]] |
| Answer E | AnswerE::Rupture of the posterior communicating artery |
| Answer E Explanation | [[AnswerEExp::Rupture of the posterior communicating artery typically causes CN III palsy in patients.]] |
| Right Answer | RightAnswer::C |
| Explanation | [[Explanation::The patient in this scenario presents with symptoms suggestive of subdural hematoma, which occurs as a result of the rupture of the bridging veins. It is often observed in elderly individuals, alcoholics, blunt trauma patients, and individuals suffering from shaken baby syndrome. A CT scan of the head would demonstrate a crescent-shaped hemorrhage crossing the suture lines. The gyri would be preserved because pressure is equally distributed due to the relatively gradual accumulation of blood.
Educational Objective Subdural hematoma results from the rupture of the bridging veins. Reference: First AID for the USMLE Step 1 2011 Pgs 405-406 |
| Approved | Approved::Yes |
| Keyword | |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |