A 78-year-old woman slips in her bathroom and strikes her head. She walks unaided for three days, then develops progressive drowsiness and hemiparesis. CT shows a crescent-shaped collection over the cerebral convexity. The haemorrhage arose from:
- A Rupture of the middle meningeal artery
- B Tearing of bridging cortical veins crossing the subdural space ✓
- C Bleeding from a ruptured berry aneurysm
- D Cortical contusion with laceration of the pia-arachnoid
Correct answer: B. Tearing of bridging cortical veins crossing the subdural space
Explanation
Chronic subdural haematoma follows tearing of fragile bridging veins that traverse the subdural space, classically in the elderly after trivial trauma, with a delayed lucid interval of days to weeks. The crescent shape on CT fits subdural blood. The middle meningeal artery produces an extradural haematoma, which is lens shaped and associated with a short lucid interval of hours, so option A is the tempting distractor.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.