QuestionSBA
QuestionChoice
An extradural haemorrhage is characterised by bleeding between the outer dura mater and the inner surface of the skull. The most common source of bleeding is a tear of the middle meningeal artery following head injury. There is typically a brief loss of consciousness, followed by regaining of normal consciousness level (the lucid interval), with subsequent deterioration of consciousness and headache.
10008145
a
Extradural haemorrhage
QuestionChoice
An intracerebral (or intraparenchymal) haemorrhage is a collection of blood within the substance of the brain. It can be caused by hypertension, a vascular lesion, trauma, brain tumour, or infarct. Patients will present similarly to an ischaemic stroke. This answer is not correct as it does not reflect the presentation described above.
10008147
c
Intracranial haemorrhage
QuestionChoice
An ischaemic stroke occurs when the brain is deprived of oxygen and blood supply. They are more common in older people and those with cardiovascular risk factors (e.g. smoking, obesity, diabetes), and are not generally precipitated by trauma. Presentation depends on the region of ischaemic damage, but can include sudden onset motor weakness, speech impairment, visual field defects and balance problems. This is not in line with the scenario and therefore not the correct answer.
10008149
e
Ischaemic stroke
QuestionChoice
A subarachnoid haemorrhage classically causes a sudden occipital headache. It usually occurs spontaneously in the context of a ruptured cerebral aneurysm but may be seen in association with other injuries when a patient has sustained a traumatic brain injury. This does not match the scenario above and is therefore incorrect.
10008148
d
Subarachnoid haemorrhage
QuestionChoice
A subdural haemorrhage involves bleeding into the outermost meningeal layer. This most commonly occurs around the frontal and parietal lobes. Risk factors include old age, alcoholism and anticoagulation, none of which are present in this patient. There is a slower onset of symptoms and may be fluctuating confusion/consciousness, making this a less likely underlying diagnosis compared to an extradural haemorrhage.
10008146
b
Subdural haemorrhage
Concept
Chapter
2693
4648
Extradural Haemorrhage
Topic
141
Neurology
14176
A 22-year-old rugby player receives a blow to the side of his head during a match. Following this, he suffers from a brief loss of consciousness which resolves after a few minutes. After this, he reports localised pain over the site of injury but no other symptoms. Later that day, he develops a severe headache.

He is usually fit and well with no regular medications.

Which of the following is the most likely diagnosis?
a